Design and Discovery

So when I start to write this, I realize that it has been a very busy couple of months.  We finally caught up on designing wedding albums and finishing picture edits from before we left for Kenya, which is a relief!  Now it's on to other projects with photography, design, video, history, and book-writing!

One of the big goals of the hospital in the past year or two has been to develop a brand.  We've done this with photography, and if you have ever worked in the corporate world, you are probably very familiar with the concept.  I was talking about it with a friend, and he pointed out what a big deal it is for things at the hospital to be done with excellence and how the 700+ employees can really take pride in Kijabe hospital and what it stands for.  

A designer came up with the first logo, and since our visit last year I've been doing off-shoots of it for different hospital enterprises, the latest of which is for the Kijabe College of Health Sciences:

Another endeavor has been a newsletter/magazine called the Kijabe pulse.  Henry, a Kenyan who works for resource mobilization at the hospital, gathers stories and photographs, then it comes to me for design, then on to the powers that be for approval, then out via email to friends of Kijabe Hospital around the world.  

Above is a screen grab of page last issue.  If you want you can see the full issue here:

http://kijabehospital.org/wp-content/uploads/2014/04/KijabePulseIssue3web-1.pdf

Next projects, video, which is newish territory for me.  Our cameras shoot video, but it is a very different way of looking and thinking than still photography.  The fun part of the video project has been catching a vision of just how remarkable the growth at Kijabe has been in the past years and will be in the future.  In the 1980's there were a handful of doctors for the whole hospital.  Now there are Pediatricians; OB's; Orthopedic, General, Pediatric, and Neurosurgeons; ENT's - the resources and quality of care this "rural" hospital provides absolutely phenomenal.  I'm excited that Arianna can be here at a time where she can develop training protocols and impart learning that will literally spread to all of Africa.  

Here's the first video we put together:

And last, but definitely not least, the Centennial Book.  The hospital is coming up it's 100th birthday, and the question is, how do we celebrate?  There have been books written about RVA and some amazing missionaries, but very little is directly about the hospital.  So I'm working with a couple of other doctor's spouses and a growing network of people who have attachments to the hospital to compile a history and storytelling record of what God has done here.  

There are some really cool parts of this project and one of the greatest so far is the treasure trove of glass-plate slides that a local historian (Shel Arensen creator of Old Africa Magazine) let me borrow to sift through.  So I set up a lightbox and photographed them, and they are absolutely amazing both from a historical and artistic perspective.  

This is a colorized slide (originally in black and white, but color was painted in) of the original Theodora hospital that was built in 1931 on RVA's campus.  But is is also a fantastic composition with the foreground, the little boy right on the third, and the repeating lines of the building.  I assume that the missing text at the bottom said Original Location of Kijabe Hospital.  

Many of the slides will forever be anonymous, but they are beautiful.  This is another colorized slide of a Kikuyu gentleman.

Many are in negative form, like these three Kikuyu boys.

Here is another negative that I almost didn't photograph as it looks like a throwaway slide.  The original was upside down when I shot it, and it shows a view of Kiambogo, the original building at RVA (where Teddy Roosevelt laid the cornerstone) with Mt. Kenton to the right background and Mt. Longonot (the volcano) to the left.  I don't know for sure, but I'd guess from the lack of structures that this image was from around 1920.  The current hospital would be in the field to the bottom left, and all around the Kiambogo building are houses and school-buildings.  Mt. Kenton has a patchwork of terraced farms and houses, and only Mt. Longonot, which is a national park (and somewhat active volcano) remains untouched today.  Looking at something like this really is like finding treasure!  

A Tale of Two Parties, by Madeline and Annabelle

Monthly blog post from the girls about their birthday parties:

Annabelle:  Frozen Freeze Party

For my birthday, I played Pin-the-Nose on Olaf and Olaf bowling. I invited my friends, their names are Finley, Brynna, Lydia, Riley, and Liam. We also did a treasure hunt and found Olaf's ice castle and tried to get him out. We had spaghetti for lunch. We had snowball fight with cotton balls.  We made snowflake wands. We did glitter nail polish and sparkle make-up.We had cupcakes and we made a cake but we didn't eat it. It was a fun party.

Madeline: Ocean Classic Party

First, for my birthday party, when everybody arrived we made pizza shaped like fish. The thing that I found really fun was making cards. One of the games we did was play "pin the tail on the orca". Another thing we did, just like Annabelle, was a treasure hunt . We had to free sea animals stuck in ice. They were hidden in funny places and it ended with fishing for treat bags. Before we knew it, the party was almost over so we had cake and all sorts of delicious snacks. This was my party for this year. It was awesome!

 

First week in the hospital. . .

I got up with the girls, combed their hair into pigtails, and drank my coffee. Then, I walked back into my room, nervously rustling through the clothes in my closet.  I have spent the first month here arranging our home and learning Swahili as fast as I can - and that day, I would walk into the hospital for the first time with my white coat.

New babies, new mamas, new nurses, new residents, new rules - the next piece of a new life.

The day started typically, with 25 babies under our team's care. The medical officers and residents scrambled to finish their notes and gather data. I watched, took mental notes, and smiled as Dr. Imma  Barasa deftly organized the chaos.

Babies in the left corner, born 3 months too soon, thriving on oxygen jetting through water bubbles and slowly needing less and less of our support as they declared to us that they would fight.

Babies along the right wall who had decided to come two months too soon, wiggling in their incubators and mother's diligently pouring milk into small tubes that stretched down their nose to their bellies.

Babies wearing cloth sunglasses, sleeping calmly under the blue lights that melted the bilirubin from their blood and others that are growing daily, fighting infection, awaiting surgery.

We analyzed numbers, changed fluids, changed antibiotics and flipped the blue lights off and on as the lab results returned. I started to unfile bits of knowledge from long nights in the NICU and nursery.

Then, a nurse arrived at the door, holding a lifeless tiny baby and placing her onto the only empty bed - we sprang to action as the nurses assembled the necessary equipment, the intern began chest compressions and I held the infants chin and mouth while Dr. Imma bagged the baby. A grimace, a kick, and then a cry as the babe realized she was in the world.

Moments later, another nurse arrived suddenly at the door and called us to maternity where a baby had been born in normal labor, but was not breathing or moving. I followed the residents lightning sprint around 3 corners, and we held the baby, cleaning him, tilted his neck, and blew air into his mouth - I worked deftly, with memory of things I have been taught well.  I felt at the base of the umbilical cord, and smiled. The heart rate slowly quickened and the baby took his first gasp for air and cried. Minutes later, we returned the newborn to his mom, alert and strong.

We regrouped in nursery, only to be called to the OR for an emergency c-section. Imma looked at me, "Can you go?"  "Of course," I replied, with more certainty than I felt - and the clinical officer and I walked quickly to the OR where I donned a cap and new shoes and a gown and waited for this tiny baby, 3 months to early, and prayed for her to breathe. She entered the world perfectly tiny, not quite ready to be born. And again the CO Robert and I pushed breath into her mouth and felt for her tiny heartbeat, and after 5 long minutes, she took her first breath. And then she cried, batted away the mask and opened her eyes wide. The resident laughed as I wished the tiny Kenyan Happy Birthday.

The week continued at this rapid, welcome pace. We welcomed more preemies, more babies with fever, another infant born with his intestines outside his body with 12 fingers and 12 toes. I ultrasounded that baby's heart and sent it to Dr. Romp in Alabama so we could help guide the infant's prognosis. I wrote Chris and asked her send bags and masks donated from Children's to friends in Seattle coming to Kijabe next week so we could replenish the stock of only 4 remaining in our hospital and continue to give life giving breaths. And I learned and taught and organized and laughed.

I woke up each morning a little less rested, but refreshed. I felt like myself again, so thankful for the privilege to do what I love. It is an amazing thing to be the hands that coax life into a newborn baby, to kneel with a mother and help her understand her child's battle, to work as a team and watch differences fade in common purpose.  I know that the days ahead will hold heartbreak as some babies cannot be coaxed to breathe and others enter the world too fragile to survive. But this week was a week of small victories and sacred moments - of new wonder and quiet gratitude in the midst of chaos.

First day picture (as I ran back because I forgot my stethoscope. . .)

Beautiful Skies and Broken Wheels

Tonight was absolutely spectacular.  This was the sky on the way home from the super-duka.  I rode home as fast as possible and grabbed the real camera. Arianna got the girls and put the homemade chips and guacamole we were going to eat for dinner in tupperware, and we jumped in the car to have a picnic and watch the sunset by the airstrip.  

Just before town, on the one 10 yard stretch of good road on our route, the car made a strange noise, as if we had run over something.  Invisible pothole?  A half-mile later, driving through town - thump, tilt, and flop.  Thankfully, and miraculously, we were only going 10 kph because the road is so bad.  Yesterday we had been driving 80 kph on the way back from Nairobi, and if it had happened then, we would have been in serious danger.   

Arianna, our friend Carola who had come along, and the girls walked home to eat dinner on her balcony. I ran to fetch the mechanic just down the road to the amusement of at least 30 onlookers, and soon all was well.  I had met the mechanic a few weeks ago, and one of the first bystanders who stopped to offer help worked at the mechanic shop.  So, we went to get jacks as the sun finally set. They lifted the car, removed the wheel, and discovered the problem was that the bolts that hold the ball-joint on the car had stripped out, fallen-off, and the last one remaining had broken in half.  

I wondered how they would tow it, but instead, they borrowed a few bolts from the other side of the car, and popped everything back together, put the wheel on, and drove it back to the shop.  We'll see what all needs to be fixed tomorrow, but it should hopefully not be much more than replacing things that are at the end of their life already.  

Arianna and I regrouped at another friend's house an hour later, strangely unfazed.  In the chaos of the night, we saw God's provision in big and small things once again. We saw the grace given to our family as our girls laughed, going to bed - safe despite a detached wheel in a new country. We were thankful for enough familiarity with town to have friends at the mechanic after only a month here. We were grateful for the wisdom that kept us from needing a tow truck. And strangely, after solving the crisis, stopping in at Mama Chiku's for a late dinner, and then returning to our house with no more pictures of tonight's beautiful skies, we felt more at home. There will be more sunsets, more crises, more provision, and more races down the road to see the beauty that surrounds us. 

The rubber and metal meets the road

The culprit

Repair at twilight (from my iPhone)

Habari za maisha? (How is life)

Maisha ni nzuri - life is good.

The past couple of weeks have been a whirlwind of mundane activity and building foundations for the coming months and years.

Our focus has been on Swahili -  lessons are an hour a day and we spend much more time studying. Though Swahili is a relatively straightforward language to learn, it has not been simple.  Many words sound like Spanish or Mandarin, and verbs in particular start to sound so similar.  Kupika means to cook and kupiga means to hit.  Kusema: to say, kusoma: to read.  Kuelewa: to know, kuolewa: to be married, kulewa: to be drunk. Then we have crazy long verbs like kusheherekea: to celebrate, and kutengeneza: to build.  And, nouns like maziwa: milk, and maisha: life.  How is your life and how is your milk are two very different questions!  

I have started my first two hospital projects - related to my background but a bit of new territory. First, I am making a short promo film for the newest  building project.  Kijabe Hospital is in a transition from being a busy mission hospital to expanding its role as a training center.  The medical officer and clinical officer training programs, surgical residencies and nursing/nurse anesthetist programs are the first of many more to come.  Arianna and her boss/mentor/friend Mardi have dreams for an pediatric acute care residency program, as do many other parts of the hospital.

I am talking to doctors who are excited about this part of their job, and others who have been through the training programs and are now instrumental in the life of the hospital and medicine in Kenya. Teaching will be the truest legacy of our time in Kijabe, and it is fun to see glimpses of how it is being done and  realize the efforts of doctors here will bring hope and healing throughout east Africa.  Pray that learning to edit video would not be too difficult!!

The second project is compiling and organizing a historical scrapbook as we approach the 100th anniversary of the hospital next spring.  This may turn out to be a colossal undertaking, but I hope it will be immensely rewarding to hear and retell the stories of the doctors and nurses who have gone before us.  

In between the big goals are the myriad of activities that make up daily life - trips up and down the hill to RVA, hardware store runs as we finish a table and benches.  Groceries at the duka, bike rides and runs, conversations with friends and strangers along the road, hosting dinner for the Pediatric department, a trip to the swimming pool with new friends, learning to start a fire with a truckload of green wood, and making Halloween (or Carnival as we call it here) costumes without the aid of Michael's or any other store.

Life is busy, but becoming normal.  And, for me, Kijabe is beginning to feel like home instead of a dream.

-David

 Madeline is a killer whale and Annabelle is wonder-woman.

 Madeline and her homemade bow-and-arrow

 Roadside sunset jumping picture

the unfamiliar

So, moving is hard. And weird. And awesome. And ridiculous.

I'm sitting upstairs while David and a friend are off taking night pictures at the airstrip in the wind in the middle of the night. Everything is quiet except for the steady howling enveloping our house, and weariness has settled in my limbs.

It has been a long day - one of those days where the world comes crashing down on you a bit - not with any particular reason or big crisis. Just in lots of little moments, where you realize you haven't found your safe place yet - that corner of the couch or cup of coffee or favorite bench where everything can sort out and make sense again.

Tomorrow marks one month since the van pulled into our house in Kijabe.

I've learned to make cookies that taste like home and coffee in a french press with unrefined sugar and cream. We've found ice cream and a cow to get milk. I can say "i'm excellent" and "i was tired" and "i will brush my teeth" in Swahili. David knows the short cuts like someone who has been here for much longer and can drive on the opposite side of the road over potholes with ease. He spent the day laughing with friends and building a table without a power saw, and then we made ham and cheese quesadillas for dinner. The curtains are hung and the canvases are stretched.  We have couches  (perfect for children bouncing), mattresses with familiar bedding, and a garden ready to plant.  The girls climb under their mosquito nets at night like they have been doing it all their lives and sprint the climb to school that still makes us lose our breath. We have welcomed people into our lives that we knew only in theory and by blog four short weeks ago, and they have welcomed us with unbelievable openness and love. We have a home, and it is wonderful.

I know this should be enough, yet it seems like these too small victories do not justify the exhaustion in my heart. Life has barely begun here, and I have yet to add the whirlwind that is the hospital to the already fragile days.

No wonder toddlers (and my youngest, daily) dissolve into temper tantrums - when every step and room and food and person is an all-consuming discovery.  When the familiar seems to change with new knowledge and the unfamiliar adds elements of un-understandable confusion that the mind can only process so fast.

Words exist for this, and  books and blogs and articles have been written about it, and I know this is expected and so verynormal. But, that does not ease the day to day - the raw guarded resolve that each morning requires.

So today, I am tired. Grateful for friends who saw subtle panic in my face and met me in the uncertainty with coffee and banana bread. Still amazed at the power of the wind and the laughter of my children as they play in the tree house outside in the afternoon light.  And still certain that this is exactly where we are supposed to be.

But overwhelmed nonetheless, and taking unsure steps, one in front of the other. Tying life in one home to life in a new home, trying to treat relationships with tender care, weaving together small discoveries into big ones, tempering the ridiculous with the wonderful, and the noise with quiet whispers.

"We do not know what to do, but our eyes are on You." 2 Chronicles 20

Heroes Day

Today was a national holiday, known as Heroes Day (Mashujaa) in Kenya.  

Rift Valley Academy celebrated Multicultural Day. . .which is quite real as the students come from a 20+ cultures and nations around the globe.  It is also a day to speak to the identity of the students as third culture kids - a.k.a. who have a passport "home", but spent most of their lives living in another place.  Many of the RVA students are technically 4th culture kids.  Imagine that you are ethnically Korean, but lived your entire life in Sudan, and now attend boarding school in Kenya. . .that's kind of the idea.  

We grown-ups attended the flag ceremony part of the day, which is like a miniature of the opening ceremony at the Olympics.  Teenagers and Titchies (Elementary-aged) from each country marched a flag to the cheers of the other students and the sound of their nation's anthem.  The traditional dress, the multitude of languages, and celebration of the students was wonderful.  One of my favorite Rich Mullins lines is "I'm home anywhere if you are where I am."  The teachers definitely reinforced this message that we should love our country and homeland, but that our true home is wherever God calls us.    

The day closed with the One World Run - a fundraising 5K through school grounds that ended on the soccer fields through a tunnel of flags from all over the world. I ran and  Madeline and Annabelle walked with their RVA big sisters, while Arianna took pictures.