Wednesday, January 27, 2010

Weekend Adventures Pt.2

This last weekend, the 22nd-24th, we made the long and bumpy trip down to Masai Mara to go on a short weekend Safari. The distance to Masai Mara from Kijabe is not a long one (around 160km) but because the roads are only paved half of the way, the rest being comparable to any off-roading experience that requires a 4x4 vehicle, what could have been a short trip ended up being a 5hour journey. The bumpy trip was worth it however because the hotel/resort that we stayed at was like an oasis in the desert. The only way we were able to afford staying at this was because out of the seven of us 5 are medical missionaries which cuts the rates considerably. Our rooms, which were giant tents with every accommodation of a regular hotel room, sat atop a twenty foot bank of a river that was filled with hippopotamuses. Again, pictures do more justice to this place than any of my words can.
We spent most of the next day and a half out on game rides searching for the Big5; lions, elephants, water buffalo, rhinoceros, and leopards. Of these we saw all but the leopard which managed to evaded us and this I half expected because if nature shows that I have watched where the professionals have a hard time spotting them during the day and they have all the time in the world. We also saw many zebras, giraffes, jackals, hyenas, the many different types of gazelles, and a number of strange but interesting birds. We didn't see any major action, as far as some animal killing another, but we did see some Thompson Gazelles chasing a jackal and I was fortunate enough to catch the lead female give the jackal a head-butt on video. As a group we took around 700 pictures and I filmed about 2hours worth of footage, so there will be plenty more to share on this trip when we get home.
Our second and last evening there we participated in the hotel sponsored Masai dinner. This included a bar-b-que of traditional Kenyan and Masai foods and we were briefly entertained by Masai warriors dancing around the fire. Because it was outside of the hotel fenced compound we had an armed guard to protect us in the case of a predator attack. However, this guy was only armed with single shot, brake-over, ancient Italian made 20gauge shotgun so I doubt he would have been much help in the event of an actual emergency. Quite honestly I believe the Masai warriors did more to detour any animals that night with all their hooping and hollering.
In all this was a great trip and one that will be best described by pictures and videos.

Coming up this weekend: Jodi and I will be hiking up a volcano because you know we cant have an idle weekend. That simple wouldn't do!

For any of you who were wondering how to pronounce Mwangi it is: Mwahng-gee. With the last part being like in Runge and the first part you figuring out on your own:)

Tuesday, January 26, 2010

Weekend Adventures Pt.1

Sorry we haven't posted in a while the internet here has been on the fritz for about a week... Wasn't great to begin with but we'll try to get a bunch on this week.

The last two weekends here in Africa have been packed full of travel, fun, and Jodi and I getting to see many different pieces of Kenya that make this country unique and special.

Starting with last weekend, the 16th and 17th, we made trips into Nairobi and down to Old Kijabe Town. On Saturday we went into Nairobi to visit Valarie’s parents, whom I had never met, and they were kind enough to show us some of the highlights of tourism in Nairobi and spend the day hanging out with us. When we first got there we hurried off to the elephant orphanage, in Nairobi’s game park, which only allows visitors for an hour on Saturday mornings. It was fun seeing the twenty orphaned baby elephants, aged two months to three years, playing around in the mud with their keepers, who take turns staying with them 24/7 acting as a surrogate mother. Jodi got some close up shots with the elephants and was even stepped on by one… good thing it was a three month old and not very heavy. After we got our fill of baby elephants, we headed off to the nearby giraffe center which is also apart of Nairobi’s game park. Here we were to get up close to the giraffes in an unusual fashion. The place has a viewing deck that is built up to head level with the giraffes and the keepers here strongly encouraged feeding the giraffes little grain pellets. These pellets must have been like candy because as long as we had them in had the giraffe was our best friend, and this again allowed us to take some fantastic up close pictures with the critters. The giraffe tongue is extremely long and sticky, so after it had completely enveloped my hand with slim one of the keepers and I were able to coax Jodi into placing a pellet into her mouth and feeding the giraffe that way. She eventually did and I was poised to take a picture but failed to capture the exact moment when the giraffe was “kissing” her… so she had to do it again! Haha!! She was a good sport and gave it another shot and this time I was able to catch the giraffe’s tongue completely covering her face. After Jodi cleaned her face off we headed to an Ethiopian restaurant, which is one of the Mercer’s favorites, to grab a late lunch. Mark, Valerie’s dad, ordered food for us since we had no clue what kind of food Ethiopians ate. The food was brought out on something like a 20” pizza pan which had thin sour dough bread made of rice lining the bottom with all the various types of food in piles placed strategically on top. Along with the pan of food came more of the thing rice bread rolled up because it is with that bread that you eat your food; evidently Ethiopians have never heard of silverware. The various meat and vegetable piles were quite delicious and very filling. That concluded the main events of our day with the Mercers in Nairobi and Jodi and I were vary thankful to have someone show us such a good time.
On Sunday we were in for an entirely different kind of adventure and we made the 45min trek down to Old Kijabe Town to go to church with Mama Joshua (our house lady). The long walk down the hillside led us through some beautiful bush country and if it had not been for Mama J’s brother guiding us we probably would not have know which of the narrow paths to take. When we arrived to the town I was at first reminded of and old west town with its row of modest shops lining the main road and the small, mostly single room, houses made of wood, tin, and mud that dotted the countryside. We went to the local Baptist church for worship that morning and enjoyed a new type of service to us filled with energetic singing and praise to God, and an enthusiastic sermon which covered the 2nd chapter of Genesis. The service lasted for a little more than two hours and for Americans who usually start tapping their watches at the hour mark this service had us so engaged that we hardly realized the time that had passed. The people of the church were extremely friendly and we enjoyed worshiping God in a foreign manner that morning. After the service we went to Mama J’s house nearby where she had prepared a rather large meal for us consisting of traditional Kenyan foods. We ate our fill, which was hardly half of what she prepared, and then visited with her and her family for a couple of hours. Again, they were also very nice; Kenyans consider it the highest honor to have friends over to their houses. We then made the hour long trek back up the hill, which took some doing with a full stomach, and by the time we arrived back home at 5 we were thoroughly wiped out.

Tuesday, January 19, 2010

Physical therapy at Kijabe

I thought it was about time to write about the work that I am doing in the hospital with Physical Therapy. In general, the hospital is setup by men’s, women’s, pediatric, ICU, private, and maternity wards. Only in the private ward do patients have their own rooms and nursing call lights. Within the individual ward’s there are 5-6 rooms, 20ftx20ft each. Within each room there is an average of 10 patient beds, a hanging sheet is the only thing that creates privacy within these rooms. The pediatric ward is separately funded from outside the hospital, so the patients have twice the space, but our area to practice pediatric physical therapy is in a large tent outside (It gets extremely hot during the day).
Overall, the hospital has a staff of 4 Kenyan trained PTs, 1 American PT, and 2 technicians. These 6 have the responsibility of all inpatient wards, outpatient, and weekly clinics (hand, ortho, and pediatric). Sherri Letchford, the American Trained DPT, is my instructor and our daily routine has never been normal. We are not sent to specific wards or clinics to see patients, but float where ever they need out help. This week and next week will be specifically working in the pediatric wards with club foot deformities, hydrocephalus, and spina bifida. Kijabe Hospital has been privileged to have Dr. Albright, an internationally known pediatric neurosurgeon, here for the past 3 weeks. He has specifically been working on the hydrocephalus, spina bifida, cerebral palsy, and neurological deformities. I was able to spend a day in his theater (Kenyan name for operating room) watching shunt placement, ETV (endoscope third ventricularotomy), and myeleomengiocele closures.
(A side note with the surgeries…) The Operating Room conditions are NOTHING like what we consider normal in America. Here they work with what they have, and never do you hear a surgeon complain about not having the appropriate instrument, drugs, or conditions. In fact…my job as an observer was ‘the fly swatter.’ Yes, during neuro surgery I was in charge of swatting the flies in the room. One last comment, prior to each surgery, everyone in the operating room stops and a quick prayer is spoken for the operation and patient.
…back to PT….I don’t want this blog to go too long, so I’m sure I’ll be sending out weekly PT updates. For now, here is one story:
Kenya has been in seeing a rapid increase in Rickets, a vitamin D deficiency, in children around 6mo to 3 yrs old. This trend has been caused by a cheap porridge mothers feed their children. This porridge advertizes “flour mix” making mothers think they are providing a well balanced porridge for their child. However, this mix contains legumes. Legumes produce phyates, an anti-binding factor that does not allow iron, zinc, or calcium to absorb. Without the absorption of these minerals vitamin D can not be produced, thereby Rickets is the end factor. Their bones become very weak, and they lose muscle function and strength. This can be reversed, depending on when they catch it and the severity of the deficiency. Children are placed on high dosages of calcium for 1 month and physical therapy is recommended. The two cases we are working with, both children are 15 months old, have lost the ability to walk, roll, and can only lift their heads for brief periods of time, due to neck musculature weakness (this leads to feeding problems). We are early on in the rehabilitation process, but usually they begin to regain function within 6months, with mild developmental delay. The sad thing is, the specific porridge that has been shown to cause Rickets is still on most shelves in the market, and the education is done only after admission to the hospital.

Thursday, January 14, 2010

Mwangi kuma America

Saturday- Sunday:
We went shopping on Saturday morning at the local supermarket in Nairobi, which surprisingly had more of a selection than I thought it would. Buying food supplies for two months was a tricky task (we buy our fresh produce and some meats locally once a week). At the end of our run through the market we had spent 15,000 shillings (KSH). After that we were driven out to Kijabe by another Mayfield driver, John, who pointed out major sites and important things in Nairobi as we left the city. On the edge of the city is a slum that holds about 1.5million people of Nairobi's 4. Had it not been for John we would not have known where the city ended because there are villages lining the side of the highway almost the whole way from Nairobi to Kijabe, which is a one hour drive.
Kijabe itself is quite picturesque and driving up to it for the first time kind of reminded us of Horn Creek because it has quite a view of the Rift Valley below. We soon found that we are staying at the home of a doctor who is currently on furlough so our housing arrangement is quite spacious and comfortable. After getting settled in we had dinner that night at Steve and Sherri Letchford’s. Sherri is Jodi’s clinical instructor and Steve doctor at the hospital. They filled us in on the do’s and don’t of Kijabe and the hospital. It has been nice having them to ask questions to and to show us around, making sure we are settled in this week.
Sunday morning church we went with the Letchfords to the RVA service up at the missionary school. It was a contemporary service with the students and was comfortable for us because it was like home but it was not very native. Next Sunday we are planning to go to the service where our house worker, Mama Joshua, goes. The rest of the day Sunday it rained so we stayed in doors and relaxed for the first time since being in Africa (this was still hard for Jodi to do).

Monday- Thursday:
On Monday morning Steve hooked us up with Charlie Besley, a Brit, who is the Medical Director at the hospital. Charlie gave us a run down of the history of Kijabe Hospital and clued us in to where we would be working and what type of environment and work to expect. After this we were both on our ways to find our roles in the hospital. Jodi already had a sense of hers and Charlie helped me to find mine by taking me to Kimani, the head of the maintenance department at the hospital.
Jodi’s first couple of days has been an up and down time for her. Jodi has had a hard time adjusting to the type of treatment that they give to people here and she constantly has to remind her self that this is not home and that they do not have all the resources or money that is available at home (However, Kijabe hospital is at the top level available in Kenya and some people come from over 150km away just to receive decent treatment). Jodi has also had a tough time dealing with her Kenyan trained co-workers who have two years of schooling after high school compared to her seven. So if you could pray for her to have understanding and patience while she works her she would greatly appreciate it. Despite these frustrating issues, she is really having a good time overall. She loves working with her clinical instructor Sherri. The two of them are practically the same person, the only difference being that Sherri is from Texas. Jodi also enjoys being able to help and treat the people who come to the hospital, giving them care that they typically might not receive. As far as working with her PT colleagues (minus Sherri), she takes every opportunity to teach them something new or make them think about how they are treating people in a different way so that the patients might receive better care even when she is gone.
My experience so far has been a great one! I was quickly accepted by the maintenance guys at the hospital, who are mostly Kikuyu and all Kenyan. Partly because of the tools that I brought and partly because of the some basic knowledge about fixing things I displayed, I am now a fundi (pronounced foon.dee and means handyman) to them. On Monday I was put to work with two Kikuyu men, one named Tosha and the other Gerald. We went spent the day fixing two leaky roofs, so right away I felt at home and comfortable. Gerald asked many questions about me and America, and honestly we probably spent the day getting to know each other more than we did working. Gerald decided that Runge was too hard for him to pronounce so he gave me the Kikuyu name Mwangi. Now all of the maintenance, security and some of the hospital staff know me as Mwangi kuma America and because the maintenance guys have been teaching me Kikuyu (which is the local tribal language) everyone is friendly and shocked when I first greet them. Honestly, we have not got as much work done as we have been visiting and teaching each other about our cultures and they teaching me their language but I am really enjoying myself. I have been asked to do two things in the past days which I have never done before. Yesterday, Kimani, told me that I would be designing a roof for a new staff housing building. I guess that he assumes that because I am a roofer that designing one will be no problem. Although installing a new roof would be no problem I’m not sure designing one would really suit me (or them) so we will see where this one goes. And today one of the older maintenance men, Stephen, asked me to give a word (which means preach about something from the Bible) tomorrow at the devotional in the morning. I told him that I would come up with something to talk about for a short while… so we will see where that takes me also!
Overall we are having a great time here in Africa. Bwana asifiwe! (Praise the Lord!)
Thank you for all of your thought and prayers. We should be in more frequent contact from here on out now that we have the internet at our place.

Brian and Jodi

Friday, January 8, 2010

Africa at last!

Well it took some doing and we got here in a round about way but finally we were able to make it to Kenya...
Our trip got off course in Chicago when our plane from London was late leaving there because of snow and thus late arriving to Chicago. Apparently the Brits have a terrible time dealing with any amount of snow because the 40cm they received in London shut the city almost completely down and threw Heathrow(a major airport in London) into chaos. When we finally did get on our way to London we were diverted(b/c of the bloody snow) to Birmingham, a 100km north of London. This caused us to miss our connection to Nairobi and kept us in the UK for the day. The airline then bussed us down to London through the beautifully snow covered England countryside and we made it to and through Heathrow to catch our next available flight at 7pm thurs. We made, at last, to Kenya at 6:30 this morning (which is 9hrs ahead of you in the mid west) to enjoy a quick day with a short nap and rapid briefing before we head out to Kijabe in the morning.
Unfortunately the high speed internet here is 256k so that means we'll have a difficult time posting any pictures, if any at all. Also, we were issued a cell phone today, on which we can receive texts and calls for free but we don't know exactly the system works yet so our number will come at a later date.

We appreciate all your prayers and we thank God for guiding us safely on our journey this far. Ta ta for now!