In previous posts and through other media forms I have tried to give a picture of the need for access to surgical care in rural Africa. Recently, this need was highlighted in a paper that was published in the Lancet and was subsequently reported on in the BBC. Please see this link to read more- No Access to Safe Surgery . The conclusion is that most of the world’s poor do not have access to adequate surgical care. This growing awareness of the worldwide surgial need has prompted brainstorming from various health organizations on how to meet this need. Certainly, training surgeons is one of the methods to help pave the way for better surgical care. This is what has drawn our family to Kenya. However, there are other ways. Surgical “camps” are one of the ways that various groups have used to try to relieve the surgical disease burden in one locality. The idea is to do as many surgeries as possible over a few days while providing this care for free or at a significantly reduced rate. Typically these camps are done in areas where there is not immediate access to to surgical facilities, and, often times, it is professionals from other countries who are coming to donate their time and expertise.
Last week, I travelled to far western Kenya along with one of our third year residents, Dr. Valentine Mbithi, for a 3 day surgical camp. This well-organized camp is at a small clinic which is run by Kenya Reflief. At least monthly, teams (usually from the U.S.) come to do as many surgeries as possible over 3 days. However, for July, the team travelling from the U.S. was lacking surgeons… which of course is a key ingredient in providing surgery. We were asked to help fill the gap and we gladly accepted. I felt like this would be a great opportunity for Dr. Mbithi and I to participate in mission outreach, plus it would allow her to operate a little more independently as we would both be running OR rooms.
We arrived on a Sunday afternoon after travelling about 3 hours from Tenwek to an area that I had not been before. The last hour was on a narrow road that twisted and turned through sugar cane farms. I felt grateful to arrive in one piece- we were run off the road twice by high speed buses who were out of control on the narrow roads. After settling in, we met the team who we would be serving with. There were four CRNA’s from various locations in the U.S., as well as a recovery room nurse. We quickly made our way to the screening clinic were we evaluated and scheduled patients for the next 3 days. The most common diagnosis was thyroid goiter. These huge goiters are often times caused by iodine deficiency and can grow so large that they cause problems with swallowing or even breathing. However, we also saw patients with hernias and other lumps and bumps. We worked into the evening, ate a big dinner, and then crashed.
By 6:30 the next morning, we were back to the clinic and ready to start surgeries. We worked out of one OR which had two surgery tables, so Dr. Mbithi and I were in close proximity. If she had a question or concern, I could quickly provide guidance. In the morning we did smaller cases independently, and as the afternoon started, we began thyroid-fest. Our team was incredibly efficient. We had almost no break between surgeries, which as surgeons, we love. Thyroidectomies are more complex cases, so Dr. Mbithi and I would work togther during the key parts of the operations, and then one of us would close the wound while the other headed to the next table to start the next case. Our team worked until 9:00 or 10:00 at night for the next two days. In two and a half days of operating, we did 24 operations. In total, we removed 9 thyroids, fixed 5 hernias, and did several other smaller operations including a lip reconstruction from a poorly healed tramatic injury. We also performed the first cytoscopy (looking into the bladder with a camera) that had been done at the clinic.
By Wednesday afternoon, we were beat. Our team members were incredible to work with and I give a big “hats-off” to Kenya Relief and the missionaries who are there on the ground making these camps happen. In addition to doing surgeries, we referred many patients who were too complex to operate on at the camp to follow up with us at Tenwek. In this manner, we were able to extend care and continuity that many short camps are unable to provide. As we drove home to Tenwek, Valentine asked me if we could bypass letting one of the other 13 residents come on the next trip so that she could return. This is what I am most thankful for… seeing our trainees develop a vision for service and outreach to those who are in desparate need.
“It’s such an honor,” we are told, “for wazugu (white people) to be invited do the final layer of the house.” We are preparing for “mudding” a house. Traditional houses here are fashioned from simple scaffolding made of sticks which are then filled in with several layers of mud. A local women’s ministry (Tabitha Ministry) works with village churches to help provide money for roofing supplies (rafters and a corrugated metal sheet) so that these simple houses can be built for widows and orphans who often find themselves without a home.
My nephews, Ryan and Eli, raised money for a house. Motivated by their upcoming trip to Kenya and wanting to contribute to our community here, they worked extra jobs around their school helping teachers clean and pack up their classrooms for summer break. They were able to earn almost $250, the amount needed to complete a house with roofing. Now, during their visit, we are going to help finish Betty’s house.
Betty, a 21-year-old orphan, has never had a house of her own. Her mother, Anna, spent much of her adult life doing anything she could to provide for her seven children…selling illegal brew and even her body. She rented rooms for her and her children in an area of town called “Satan’s Den.” In her last years of struggling with HIV/AIDS, Anna came to know Jesus. She grew in her faith through the Tabitha ministry’s Bible studies. She spread news of Jesus’ love throughout Satan’s Den, and began sharing Him with her children. Anna lost her battle with HIV/AIDS in 2010. Betty turned from God for a time in the aftermath of her mother’s death. Now, Betty is striving to follow Jesus and trying to create a home for her younger siblings.
“The final layer is special,” we are told, “because it is a mixture of clay and animal dung, which provides a protective layer to the walls.” (Yes, animal dung…a nicer way of saying “cow poop”). So we scooped up large, dripping, smelling handfuls of the thick liquid and “painted” the walls with our hands. The ladies show us the proper technique…both hands, large sweeping motions, smoothing it into all the cracks. There’s no halfway effort to this. Doing it right means that the warm liquid runs down your arms, dripping onto your legs and toes. Throughout the day, as our “paint” mixture gets low, the ladies disappear and return with large buckets filled with fresh dung to replenish our supply. Nature’s supply shop…
A thicker gloppy mud is also made to fill in the space between the roof and the upper edge of the wall. This mixture is made by digging up dirt in a hole, adding water, then stomping on the mud until it is just the right consistency. Our kids all love this part!
After finishing the inside and outside walls of the house, we wash up (in buckets because there is no running water) and share a meal in the new home with Betty and her family. Neighbors and friends keep squeezing into the freshly mudded room, unhindered by the flies or the odor. Scriptures were read and songs were sung…giving thanks to God for His provision and praying His blessings on the home. What a beautiful picture surrounded us of God providing through the body of Christ not just for Betty’s practical needs, but restoring hope and joy and family.
Yesterday, while celebrating the admirable earthly fathers in my own life, I couldn’t help but think of Betty. I pray that she knows more strongly each day the love and security of our Heavenly Father who adopts us all as His own into His eternal family.
Rejoice before him – His name is the LORD.
A father to the fatherless, a defender of widows, is God in his holy dwelling. God sets the lonely in families, he leads out the prisoners with singing!
“Let us pray for our Mothers… Because sometimes they die giving birth.”
This. A simple prayer request. Jolting in it’s content. But even more so because it was spoken by a 10-year-old boy, in his clear and crisp Kenyan-English accent, standing up bravely before a large church congregation.
It was our first Sunday to attend church at Tenwek after we arrived last fall. Inquiring later, I learned that this young boy is not an orphan, not motherless… Just a child growing up in a place where pregnancy holds as much risk as promise.
Many have asked me, “What about OB? How is your work?” I haven’t shared about my experiences in “Maternity” because, frankly, I don’t even know where to start. How is it possible that my previous and current worlds of obstetrics and gynecology even exist on the same planet? How did a trip across the ocean take me from a practice where I discussed with my patients the risks and benefits of epidurals, explained the evidence behind prenatal screening tests and childhood vaccines, reviewed the merits of personal birth plans, met with privately hired doulas, and even assisted in planning gender-reveal parties…to a place where the children in my community literally fear for the lives of their mothers.
I knew the statistics…I had shared maps and numbers and percentages with many of you in our days of preparations to help flesh out the “whys” that motivated our move to Africa.
Statistics like this:
- 800 women die EVERY DAY in the world due to pregnancy complications
- Almost 2/3 of these deaths are in Sub Saharan Africa
- The lifetime risk of dying due to pregnancy for a woman in Sub Saharan Africa is 100 times greater than for a woman in America (100 times!!!!)
And maps like this:
But beyond the staggering statistics and dramatic maps are real people. These numbers now have names to me. Dorcas. Mercy. Nellie. Faith. Evelyn.
And they have families. Children left without a mother… sometimes newborns who I brought into the world on the brink of their mother’s departure from it.
Most maternal deaths are preventable, which makes the stark contrast between my two OB worlds even more difficult to reconcile. But too often, by the time mothers arrive to our facility, they have crossed a critical threshold beyond which our medical interventions have little chance of changing their outcome. Hemorrhage starting 24 hours prior to arrival with cardiovascular collapse already progressing too quickly. Infection setting in days ago, unrecognized or ignored, with septic shock already taking over. Advanced stage cancer, untreated, with severe malnutrition, in a body unable to withstand the strains of pregnancy any longer. Preeclampsia, unrecognized in a village clinic, with convulsions and loss of consciousness beginning several hours before arriving to our facility.
The reasons behind this unacceptably high death rate in mothers worldwide are complex and multi-faceted… Inadequate numbers of skilled health workers (trained nurses, midwives, or doctors), long distances to health care centers, poverty, cultural practices, and lack of information. Improving maternal health was 1 of the 8 Millennial Development Goals adopted by the international community in 2000. Improvements worldwide are being made. Maternal death rates are decreasing, but much too slowly to reach the proposed benchmarks by the goal of 2015. And there are still huge discrepancies between the rich and poor, and between those in urban and rural areas.
But my purpose here is not to fully expound on these reasons, or even to explore the many possible solutions, but rather to share about the beautiful and strong and brave women of my new home. They are remarkable…bearing incredible difficulties and sufferings with stoic grace. They love their children fiercely, dream expectantly, and persevere in amazing ways to care for their families. Their “barriers” to adequate health care are now the backdrop of my life. And it’s not OK.
Frustrated. Perplexed. Discouraged. Heartbroken. Indignant. These emotions co-exist within me on a regular basis in my new “normal.” In 9 years of private practice in America, I never lost a patient. Our team here lost 9 mothers in the month of January alone…4 more in February. And it’s not OK.
God does not ignore these strong and conflicting emotions. He has much to say about death and discouragement and earthly pain in His Word, because these elements surround us in this world if we are willing to see them. He uses words like “groan” and “burdened” and “grieved” and “afflicted” to describe our time on earth. But He also gives us the assurance that this is not how He intends for things to be. Yes, we protest against death with every fiber in our bodies; because we are created for eternity, not for these weak and temporary earthly bodies. And while I may not be able to save the life of every mother brought into my care, I am given promises to which to cling.
…Promise of death defeated… “He will swallow up death forever; and the Lord God will wipe away tears from all faces,” (Isaiah 25:8)
…Promise of light overcoming darkness… “The light shines in the darkness, and the darkness has not overcome it.” (John 1:5)
…Promise of GOD with us… “For it is God who works in you,” (Philippians 2:13)
…Promise of eternity… “But our citizenship is in heaven, and from it we await a Savior, the Lord Jesus Christ, who will transform our lowly body to be like his glorious body,” (Philippians 3:20)
So let us pray for our mothers, and for us all, that we not lose heart.
“So we do not lose heart. Though our outer self is wasting away, our inner self is being renewed day by day. For this light and momentary affliction is preparing us for an eternal weight of glory beyond all comparison, as we look not to the things that are seen but to the things that are unseen. For the things that are seen are transient, but the things that are unseen are eternal.” (2 Corinthians 4:16-18)
This year, our Christmas has been quite different from years past. While we have certainly missed family and familiar traditions, we are so grateful for the many new joys that God gave us here to make this season special. We thought we would share some pictures to give you an idea of our Kenyan Christmas…
We enjoyed hosting a Christmas party for the surgical residents.
The residents playing “reindeer games!”
This year our gingerbread houses had to be made from scratch. I think we have a new tradition!
The MKs made decorations for the pediatric ward at the hospital, then spread some Christmas cheer by decorating the ward.
One of the girls’ favorite times this season was Christmas carolling though the hospital wards. Instead of carolling, I was busy on call that night. These babies were serenaded moments after their birth.
The kids packed 265 backpacks to give out at local orphanages. On Christmas Eve we were able to help host a Christmas party at one of these children’s homes and give out some of the backpacks. We all had so much fun celebrating with these sweet children!
On Christmas Eve we worshipped at church, focusing on God’s gift in His son Jesus that gives us such cause to celebrate.
On Christmas morning, we learned that “Santa” doesn’t just come from the North Pole…This year he came to us from Tennessee, North Carolina, Georgia, and Colorado! Who knew?!
We walked across the river to a friend’s house for chai (hot tea) and mandazis (a sweet fried bread), which is a traditional Kenyan Christmas treat.
On Boxing Day (December 26th) we got to welcome some dear friends to Tenwek for a visit. Debbie and the Newman Family did pre-field training (MTI) together with us in May. It was wonderful to reconnect on this side of the ocean!
Christmas hair!! So an interesting change takes place around these parts at Christmastime…all the girls and ladies get fancy hair-dos for Christmas! This especially transforms the little girls, who the rest of the year have super short hair (like at their scalp), but now have long pony tails and fancy styles. Rees begged for some Kenyan Christmas hair…so here she is!
Living on the equator means sunshine and warm weather and lots of outdoor play, even at Christmastime!
And last, but most certainly not least, I brought in the New Year by bringing this miracle baby into the world. She was delivered shortly after midnight in the ICU to a very sick mama who has a skeletal deformity of the chest causing severe pulmonary hypertension and respiratory distress. The decision was made to deliver this baby at 32 weeks gestation due to the mama’s worsening condition. At this state of prematurity, many babies here don’t survive (we don’t have ventilators designed for premature babies), but she came out crying and kicking and is doing great!
Happy New Year indeed!
(By two MKs)
10. Sleeping under mosquito nets
9. Having pets (so far…a dog, rabbit, 2 hamsters, and an occasional chameleon)
7. Getting mail and PACKAGES!!
6. Rarely driving anywhere (We walk to school, dukas (local shops), friends’ houses, etc.)
5. Animal on the roads (donkey, cows, sheep, goats, chickens, zebras, baboons, even lions if you’re on the Mara)
4. Friends readily available to play with…all day, every day!
3. Climbing trees
2. Going barefoot
1. Being together more as a family and eating lunch together every day!
I am sweating and my heart is racing. Twinges of panic appear but are then suppressed by thoughts: “How are we going to stop this bleeding?” “Where is it coming from?” “What happens if we can’t- I know the answer to that.” More twinges of panic. “Lord…help…” Blood fills the wound through a large crack in his skull. There are three of us working together: 2 residents and myself. I am supposed to be the experienced surgeon guiding the inexperienced through an operation that I have become confident doing through years of trial-by-fire. But I am not trained in neurosurgery and the brain seems a long way from the gallbladder right now. Bleeding continues. More sweating. We work together. One of us suctions, another elevates a fragment of bone away from the boy’s brain, and the other is ready with some packing to fill the hole to arrest the bleeding….
Several hours earlier, the young boy had been crossing the street when he was hit by a “boda-boda” or a “piki.” What we call a motorcycle. Motorcycles are a cheap form of transportation in a part of the world where the vast majority of people cannot afford a car. It is not uncommon to see 3, 4 or even 5 un-helmeted people on one motorcycle. But this child was just walking on the side of a congested street when he was struck. Following the accident his mother brought him to Tenwek where our team first evaluated him in “casualty”- the ER. He was 7 years old, but small for his age and had a big gash on his forehead. Fortunately he was awake and alert and it seemed that we would be able to just sew up his wound and get him home. But things changed. He started having seizures and became unresponsive to the point that we had to insert a breathing tube. Quickly he sent him for a CT scan which showed a depressed skull fracture with fragments of bone impinging upon his brain which was the likely source of his seizure. The fracture was located very close to a major blood vessel beneath the skull called the sagittal sinus. I would have rather avoided operating due to concerns of violating the wall of this vessel which can lead to heavy, difficult to control bleeding. But with his declining status, we did not have much of a choice so we proceeded to surgery…
With the packing, the bleeding has stopped for the moment. We gently lift additional bone fragments out of the wound and then wash out the dirt. There is a tear in his dura- the lining around the brain which contains the clear fluid that bathes the brain and spinal cord. With fine suture we carefully sew this up. I breathe a sigh of relief as it appears the bleeding has mostly stopped. A few fragments of bone are replaced like a jig-saw puzzle to fill the bony defect and then we closed his soft tissue and skin.
After taking him to the ICU still on a breathing machine, I walk home. It is late and I am having a hard time dodging mud puddles in the dark. The stars are out and it is a beautiful night. I am filled with contradictory emotion- I am grateful, I am relieved. But I am uncomfortable and humbled in this place where God has led me. I really want to sneak away to the airport, hop on a plane and fly back to the life I had. A life where I had most things figured out. But I know that that is not possible anymore. I am filled with passion for the work here- passion that could only come through grace. Passion that is impossible for me to generate on my own. Passion for the residents who are seeking to serve their people better. Passion for the patients who are enduring in the midst of incredible suffering
On rounds the next morning, the young boy is awake. He has already pulled his breathing tube out himself and he looks at me with an expression that says: “Dude, what was up with that breathing tube? And why do I have a killer headache?” He makes a great recovery and goes home a couple of days later. Have I simply failed to see God’s hand working in the past? Or is it only when I am stretched beyond my limits that I am able to see him working? Or is it that his strength is made perfect it my weakness? Likely all of the above.
“Back To School”
Since so many have prayed for and inquired about our schooling situation, I decided to give a brief description of our school days here in Kenya. The title of “Back To School” just didn’t seem right given that the word “back” implies a return to something known or familiar, whereas this year school resembles nothing familiar to our family!
The girls are part of a “school” that is a unique hybrid of individual homeschool and co-op classes with other missionary kids (MKs). The Tenwek community has about 30 MKs this year, ranging pre-K through junior high. We moms have all pooled together to meet the educational needs of our children. Some of these moms are teachers by training. Others are doctors (me!), nurses, and even a landscape architect. We may differ in our backgrounds, training, and personalities, but we all have in common a call to serve God’s Kingdom in East Africa and a need to educate our children! Most years there is a teacher here who is instrumental in meeting these schooling needs, but this year our teacher had to leave the country unexpectedly (due to denial of her long-term visa). So…after many meetings…Plan A, B, then C…school started last Wednesday! Here is what it looks like for our girls…
Rees is in a 4th/5th grade group of four children (with three others coming later in the year). They have four different teacher-moms in three different classrooms locations (in houses). Other missionaries are typically referred to as “Aunt” and “Uncle” here. So Rees has “Aunt Jenny” teaching history, science, and spelling/vocabulary, “Aunt Ashleigh” teaching writing/composition, and “Aunt Angela” (me!) teaching literature. I also teach her math (on her own) and Bible. These classes fill the morning hours (8:00-1:00). In the afternoons she has art, PE, and science lab on various days. So far she loves her new school routine!
Mary Taylor is with a 1st grade group for all of her “core” subjects. Her teacher is “Aunt Erin” and her classmates are all boys. The first grade schoolroom is in our basement, so she simply walks downstairs in the mornings. Bailey (the dog that we are dog-sitting this year) will often wander downstairs to check on her during the day!
School in this setting comes with some new and interesting rules, such as, “No chameleons or dogs in the classroom” (although they often show up uninvited). And “Shoes not required.” There are also unique challenges. For example, this week I had to extend a deadline on a research assignment because of power and internet outage for 2 consecutive days! Being both “mom” and “teacher” holds a new challenge for me as well, and is one more addition to my growing list of “Daily Out-of-My-Comfort-Zone Experiences!”
Despite the challenge, I am so thankful that God has called us to a place where our children have community and classmates. I am so thankful for the resources and ability we have to educate our children well. I am reminded daily that for many Kenyans, education is not so easily obtained. For example, for children in Kenya, public schooling is not offered past elementary school. Attending “secondary school” (junior high and high school) is an expense that is far beyond reach for many families. Even for elementary students, many fees are required. If these fees have not been paid in full, the children are sent home from school, not allowed to attend until the fees are paid. One of our new Kenyan friends is a single mother of five children, all in school, ages ranging 3 to 17 years old. Her husband passed away unexpectedly while she was pregnant with her youngest child. Her two children in elementary school leave home each morning at 5:40 am to walk to school in time for their 6:30 am start time. They are dismissed from school at 5:30 pm to walk home! Yet she has such a joyful and thankful heart, always a radiant smile on her face, expressing that she is thankful that God has given her work that lets her provide for her children and thankful that her children are receiving such a “good foundation” in their education through school.
Thank you so much for the many prayers for our family as we transition into our new normal. Please also pray for our new Kenyan community, for the many families who struggle to provide their children with educational opportunities, for the many orphans without parents to advocate for them, and for the compassionate ministries here as they seek to help those children in need in meaningful ways…always pointing them toward the One Provider who is our only true hope.(I’m hoping Heath will write our next post, entitled “
We are in what some would call “chaos”. This time of transition, which can take from several months to a couple of years, is stressful and represents “culture shock” in the true form. This is not the short term culture shock that one experiences on brief trips such as being appalled by bad smells or feeling overwhelmed by new and strange sounds. This a deeper, more profound sense of being out of place in a new culture and disconnected from one’s home culture. We are currently in what is called the honeymoon period where everything is new and exciting. But it is also a time when we are trying to sink our teeth into the Kenyan culture which will ultimately allow us to better minister to the people we are serving. Connecting better with the culture here can also potentially soften the blow of culture shock down the road, at least in theory. Language acquisition is a big part of learning the culture as it provides a direct way for us to interact with Kenyans. The challenging part of this period of growth is that it is a process. It is a humiliating, frustrating, embarrassing, funny, but ultimately very rewarding process. We thought we would share some of these experiences.
It is amazing how unfamiliar words and sounds carry so much meaning. In Swahili, a single change in one vowel can communicate the difference between “to be drunk”, “to understand”, or “to be married” (kulewa vs. kuelewa vs. kuolewa). For a newbie-Swahili speaker, this can spell disaster. Fortunately, we have excellent teachers who have pointed out these language land mines so we can avoid making some embarrassing mistakes. However, I am a slow learner, and generally learn best by trying a bunch of wrong ways first. An important part of our day is spending time with a language helper. These are Kenyans who come to our school to sit and chat with us in Swahili. The first week, my language helper and I just stared at each other in uncomfortable silence as all I could say was, “Jina langu ni Heath.” After 15 minutes of repeating what my name was, it was clear that my helper was bored and could not understand why I have such a weird name. But as we have progressed, the conversations have gotten longer and more interesting, and with this has come as many mistakes as there are correct pronunciations. The other day, I was discussing my favorite foods with my helper. I eagerly explained that my favorite food is beef, which in Swahili is said “meat of cow.” As I finished, I glowed with pride that I was starting to actually be able to communicate. But my helper began to smile. First just a little, then a lot. “What?” I asked. “You just said your favorite food is cow butt.” “Oh…”
So, that is how it goes. But recently, I have been able to use Swahili to actually communicate important information. For several nights in a row, one of the guards who patrols the grounds where we are staying sat by our window and played music on his cell phone at maximal volume. It sounded like a distorted Swahili version of “Party in the USA” by Mylie Cyrus. It was funny the first night, but by the third night of our girls not sleeping well because of the music, I decided I needed to say something to him. I carefully planned the Swahili words I would use, then went out and explained that our girls were unable to sleep and asked if he would mind turning his music down. Graciously, he stopped playing it. However, I felt bad because here was this guard protecting our house and vehicle, and I wouldn’t even let him play his music. So, I decided that I would give him an extra pair of ear buds which we had brought, and he seemed very pleased to have them. As I walked back inside, I felt good that I had been able to solve a cross-cultural dilemma with both sides feeling happy. “Maybe I am cut out to be a missionary,” I thought. Once back inside, I began to hear what sounded like a dying cat singing Mylie Cyrus in Swahili. It was the guard singing his heart out to the music that only he could hear through the ear buds. I guess he had never used ear buds before, and he seemed to have no idea how loud he was. Angela laughed so loud in response that it woke up our girls who then they couldn’t go back to sleep because of the singing.
Another way we have been learning the culture here is through stories told by our Kenyan instructors. The other day, one of our instructors, who had grown up in a remote area of northern Kenya, told us a hunting story. He loves to hunt and hopes to come to the U.S. someday to shoot some bears. Several years ago while hunting in a remote area of Kenya, his dogs cornered a jaguar. Now, most Kenyans would prefer to avoid jaguars, however, the big cat began to attack one of his dogs. In response, the hunting party was forced to kill it. After jabbing a few spears into it, our instructor went to roll the animal over only to discover that it wasn’t completely dead. The jaguar attacked and ultimately was shot, but not before rewarding our esteemed teacher with several wounds whose scars are still easily visible today. I was quite amazed by this story which apparently showed in my expression. He asked me if I had a story like that, and without completely thinking through my response I said “yes”, and I proceeded to tell him about the time when I found a stray kitten in Angela’s grandmother’s barn. When I had tried to pick up the fierce kitten, its mouth clamped down on my finger giving me a nice puncture wound. After a trip to the ER, a tetanus shot, and a course of antibiotics, I made an uneventful recover. When I had finished my wild animal story, our teacher just stared at me with similar amazement that I had showed him. Although, I would imagine he was amazed for different reasons. What a display of the contrast between our two cultures.
Despite embarrassing moments, set-backs, and struggles we remain grateful for these experiences and for new friendships. I have looked forward to practicing medicine in a place with such tremendous need, and indeed, I am counting down the days until I am able to get back into the operating room. However, this time in language school has been an incredible time of learning and transition which I would not trade. Next week, we leave for Tenwek to start yet another transition and do so with anticipation and gratitude, humbled by being strangers in a strange land- at least for the moment.
This summer has been spent very differently for us than any summer past. Instead of family vacations, cook outs, and days at the pool we have been learning a new language and adjusting to life in a foreign land. Some of our favorite memories of summer in our “Knoxville home” are of days spent on the lake. So when we had the opportunity to visit a nearby Kenyan lake, we jumped at the opportunity.
In Kenya, the 4th of July is not a holiday. But since our language school currently has mostly students from “Marekani” they decided to give us all a holiday on July 4th. We already had plans to visit our field director in another town, so decided to stop at Lake Naivasha on the way. Crescent Island juts out into this large lake, housing many wild animals (minus the predators) allowing for an amazing “walking safari.”
We took a picnic lunch and explored the island, walking alongside giraffes, zebras, wildebeests, cape buffalo, water buck and gazelles. Our boat ride included sightings of many amazing birds and some close-up visits with hippos. This was a little nerve-racking considering that more people are killed in Africa each year by hippos than any other animal. No skiing or tubing in this lake!
It was a surreal experience to “celebrate” our American Independence Day in this new land that we now call “home.” Surrounded by God’s amazing creation in the Great Rift Valley of Africa on that day, I was aware in a new way of God’s greatness. I am so grateful that God’s love and redemptive plan transcends culture and patriotism and language and earthly nations. I am so grateful that we live under the promise that one day people of every ethnic group and every tongue will be praising God together…a true “One nation under God.” I pray daily in this new place that God will give me His eyes, erasing any cultural bias from my heart and mind…that He will let me see the culture and people around me as He sees them and allow me to love as He loves.
“After this I looked, and behold, a great multitude that no one could number, from every nation, from all tribes and peoples and languages, standing before the throne and before the Lamb, clothed in white robes, with palm branches in their hands, and crying out with a loud voice, “Salvation belongs to our God who sits on the throne, and to the Lamb!” Revelation 7:9-10 ESV
“Praise the Lord, all nations! Extol him all peoples! For great is his steadfast love toward us, and the faithfulness of the Lord endures forever. Praise the Lord!” Psalm 117 ESV
Greetings from Kenya! What a whirlwind the past few weeks have been. In just the past couple of weeks we packed our 27 pieces of luggage, closed on our house, sold our furnishings and our last remaining vehicle, traveled via U-haul to Atlanta, said goodbye to family, flew to Kenya, and started language school. We arrived to Nairobi feeling relieved to finally be here and grateful for how God has prepared the way.
Our journey to Kenya began in Atlanta. As we pulled up to the departure zone in a U-Haul loaded down with all of our luggage, we were greeted with wide-eyed stares from the baggage attendants who were waiting curbside. “27 bags? How many people? Four?! Hey man (yelling to his buddy), these people have 27 bags for 4 people!” This remark was repeated in astonishment to each person we encountered. Gradually, we proceeded through the check-in process, watched our bags and foot lockers be checked, and then made our way toward the gate. We travelled through Chicago, London, and then ultimately to Nairobi over the course of the next 24 hours. When we arrived in Nairobi, it was after 9:00 pm, so we quickly got our visas and went on to collect our luggage. Again, baggage attendants (this time Kenyans) asked us how many bags we had and whether we needed help. “You have how many bags? 27? How many people? Four?!” He then yelled to his buddy in Swahili, that I suspect if translated would sound something like, “These crazy four people have 27 bags!!” After collecting our luggage we made it through customs, and then hauled our things on 6 carts out into a rainy African night. Thankfully, our field directors met us outside and helped shepherd us to 2 vans which took us to a guest house where we all crashed and burned.
Over the next couple of days, we did some shopping in Nairobi for essentials and then travelled to the town where we will be staying for the next 2 months of language training. At this point we have a grand total of 10 days’ worth of Swahili-learning under our belts, so we know just enough to be very amusing to our Kenyan friends. Our girls are taking Swahili classes in the morning, and Rees in particular soaks up vocabulary knowledge like a sponge. Ahhh… to have a young brain! Overall, our time thus far has had both challenges and rewards:
Challenges: We were once highly efficient people…but not anymore. Almost everything we do takes more time, more work, and more brain power than expected. From preparing meals, to doing emails, to brushing our teeth, things are just different. Fortunately, many aspects of our life are much simpler. For example, we spend less time doing things like driving a car to work (we walk to class just around the corner) or watching TV (there is no TV). One of the more interesting challenges has been the temperature. Typically, the lows are in the upper 40’s to mid-50’s. Highs sometimes get up to the upper 60’s, but only if the sun is out. Doesn’t sound too bad except that there is no indoor heating. Even if the temperature in the house is in the upper 50’s, it feels really cold and we bury ourselves under piles of blankets to stay warm at night. In our short time here, we have also had a number of interesting encounters with bugs in our house. Part of the problem is that we have no idea which bugs are harmless and which ones are not. I (Heath) found a really cool looking black and red bug crawling on the wall the other day which I flicked off the wall with my finger. Someone explained to me later that it was a Nairobi Eye and that when squashed it releases some type of acid which causes burns on the skin. What!? Angela (who would never describe any bug as “cool”) closed the curtain one night to be met by a very large and hairy spider just hanging out on our curtain. Not cool!
Rewards: Despite expected and unexpected challenges we are blessed with many rewards. Kenyans are very hospitable people who laugh easily and are a joy to be around. Our Swahili instructors are all Kenyan, so classes (despite being a challenge due to the large volume of material) are full of laughs. Kenya itself is beautiful. Over the weekend, we journeyed across the Great Rift Valley on our way to Tenwek for a quick visit. It had been 14 years since our last trip through the valley and I had forgotten how big and amazing it was. Mary Taylor would say that all of the chameleons have been a big reward. Typically she has 2 or 3 of these slow moving lizards crawling on her at any one time. She names them all and calls them her “pets” although so far we are not letting her keep them inside. Yesterday, while hiking, she carried one on her head. Kenyans really do not like chameleons, so when they passed us on the trail, we were met with wide-eyed stares of horror. Overall the rewards far outweigh the challenges, and we feel privileged to be able to serve in this place.
For the next 2 months we will remain at language school, and then in mid-August we will transition several hours west to Tenwek. Please continue to pray for our transition to our new culture as well as for “young”, absorbent brains so that we learn Swahili effectively. Please also pray for our daughters. They are clearly in a period of adjustment and our move has been challenging for them as well. Finally, continue to lift up the surgical residents at Tenwek Hospital. These young doctors are the future of Africa and it is our prayer that through them, with the Lord’s guidance, the kingdom will grow in the region.