Day 7

Today was a quiet one as Sundays often are.  We woke up early and went to English church, which was absolutely packed. . .so many people that they couldn't all fit in the building, many of them school-children (I wonder if it is compulsory??).  The we went to lunch with the Matsons, had a rest and played the rest of the afternoon with our new Kenyan friends.  Arianna had to go in a little bit this morning, but had a good rest in the afternoon and is now back at the hospital for call tonight.  Hopefully tonight won't be too crazy for her!

Prayer request - they lost one little one tonight and another, Jackson, is in very bad shape.  Please pray for the families and little Jackson.

 African Inland Church

Arianna gets a new hairstyle!  

 banana tree

 lemon tree (lemons are green. . .are limes yellow??)

 Kenyan friends

 Sunset

Panorama from our house. . .just left of center if you were to drive over the mountains would be Masai land and the Serenghetti.  The mountain to the right is Longono - a volcano with a blown out crater in the top.  It looks like a normal mountain in most of my pictures, but supposedly zebra and wildebeast live inside the rim.

Day 6

Arianna's thoughts on this week: 

The medicine side of life here is painfully beautiful and full of paradoxes and balances and joy and frustration.  Yesterday made me laugh at how much I have settled in, however.  One of the long term doctors asked me if I had taken pictures of my patients. .  .”Of what?” I replied. . . thinking things were quite normal and that pictures were unnecessary.  Then I thought through the patients I have been covering. . .

The countless patients with severe hydrocephalus we are working with to gain weight. . .with heads the size of volleyballs that smile and coo and laugh with me every morning.

The child with epiglottitis, rarely seen in the states,  and profuse drool pouring from her mouth in near-kidney failure from dehydration, who we watched carefully and cautiously off a monitor and on IV fluids who slowly got better and will go home today.

The micro preemie who was born to a teen mom on my call night with fused eyes that was breathing beautifully on a wisp of a nasal cannula.

The tiny 1 year old with liver failure and a beautiful smile.

The combative one year old baby who came in today with kidney failure, trouble breathing, and seizures and fever. I have no idea what is wrong with him, but the ICU nurses are graciously guiding me through his care.

And then the countless children with pneumonia and bronchiolitis who remind me so much of my patients in the states with worried mothers and bright eyes struggling  a bit  for each small breath. . .

I am spent and exhausted and exhilarated. I love being able to teach my residents who work 100-120 hours a week with a smile and no complaint. I love praying with my patients and my parents and knowing it is the most important and powerful thing I have to offer. I love knowing that what I am doing is good, but feeling so tangibly, that in the end, what I have to offer is so little compared to His healing.

I have managed patients in the last 5 days that I would have thought impossible in the States, and the patients are improving. And some are getting sicker when they should be fine. It is the art of medicine at its very core.

Prayer request for today - Arianna is on call again tonight, so pray for her ability to do her job well and fight through the exhaustion.


I (David) started out early today (finally slept through the night last night - yay!) walking Arianna to the hospital and then I took a stroll through the cemetery on the way home.  The graves are mostly missionaries and hospital workers - people who spent their lives serving the people around Kijabe. . .some lived full lives, and one lived two days.  My favorite by far was one that read.

TOM COLLINS

1910-1964 

PIONEER MISSIONARY

1934-1934

HE LIVED CHRIST

What a great statement. . .he lived Christ. . .he went to remote places and to borrow a Young Life term, he was Jesus with skin on.  Well played John, well played.  

Then we went to the market and hardware store. . .it's amazing how much comfortable I am knowing that I can get a few tools and things if I need them. . .and cheap too!  We picked up wood glue, paint to fix up the house, and a light bulb!  There are a few shops that expressly cater to Wazungu (foreigners) close to the hospital, into which were as far as we had ventured before. It was fun to walk past that into the Kenyan part of the village - tailors, cobblers, hair salons, etc.

 the tailor's sewing machine

 the hardware store

The monkey tree in the front yard (I can see 4

but there is a 5th somewhere in the tree)

baboons under the monkey tree

Then we came home and played and played and played and played, climbing trees, swinging, making flower soup and mud cakes, hunting and tackling each other. . .  We haven't seen many Kenyan kids until today because they are at school most of the days, but today they were out in full-force and a few wanted to play with the girls (maybe out of curiosity, but I think because they have to have adult supervision to get access to most of the playgrounds nearby).  Whatever the case, by the end of the day, they were all great friends.  I really want the girls to get to know Kenyans, but at the same time it has to happen at a pace they are comfortable with and in settings where they feel safe - walking through the market and playing this afternoon were perfect.  Keeping up with 9 kids is tough, but it is fun to see them so happy!  

Another great sunset!  I went to take a few pictures from our neighbor's yard and ran into a group of teenagers from Raleigh.  They were attempting to start a fire, so I grabbed my new "masai" knife (goodness knows who actually made it) and chopped some kindling Bear Grylls style by hitting the knife through the wood with a rock.  Good times, and fun to hang out with some teenage boys for a bit, it's good for my immature side!

Day 5

Today I had my first Swahili lesson.  This is language number 6 to be studied in my life, and I can presume that I will work hard, learn a bunch, and retain just a few phrases a year from now!  But it will make it so much easier to have a foundation when we do move over more permanently.  I think it may be the lack of sleep last night combined with the sheer amount of information we covered in an hour, but it wiped me out!!  

A few interesting notes if you’re linguistically inclined - baba & mama (father and mother) are the same in both Swahili and Mandarin Chinese, but unlike English dada means sister and papa is shark!  All words end in vowels, which makes the language quite musical, and has to be a dream for poets and songwriters.  Hivi hivi means so-so, just like the French com-ci com-ca and the Chinese mama huhu (which literally is translated horse-horse tiger-tiger, but means so-so for a reason I don’t know so). 

The girls sleep super-late so they missed the lesson, but it was fun to sit down with them afterwards and go over the highlights – how to say hello and respond, how to knock on a door (hodi), invite someone in (karibu), and to say “I’m doing well” – (n’zuri)  Madeline has a notebook in which she writes down everything important to her on the trip and the Swahili lesson is fun to see in her own handwriting! 

Arianna got creamed today. . .I can’t understand how she is still standing (well technically she’s not as she crashed just after dinner!)  The hospital is incredibly busy and very short-staffed with many of the doctors on furlough, and I’m not sure how the wards would have functioned without her this week.  She’ll update on the medical side of things soon, but there are cases of pneumonia, T.B., trouble breathing, hydrocephalus, and meningitis – pretty much all combined with failure to thrive.  I walked over to bring her lunch today and met the father of one of her sickest patients, a boy with cancer on his spinal cord who had complications after a surgery and is now comatose.  The father was incredibly kind, thanking me for our prayers, thanking Arianna for her care. . .he has started several churches in his home village and is altogether a wonderful man.  We pray for a miracle for his little boy. . .and I am floored by how someone in such a terrible situation could be so kind to strangers.  This in all honesty is one of the things Arianna looked forward to most about practicing in Africa. . .in the states doctors are often vilified and rarely thanked – we think that all patients should be treatable and if they do not have a good outcome it is the doctors’ fault.  Whereas here, this little boy, like so many of these children, would die without the care provided at this extraordinary hospital. . .and his father is so grateful. 

I met up with Phil this afternoon, a young man I met at the Supa Duka (grocery store) yesterday.  He is doing pastoral training seminars all around Africa this year and we talked for a bit at the store and then a lot more this afternoon.  Like me he is a bit of an outsider in Kijabe, not being a part of the hospital or school or college, so it was good to have a chat about life and theology and what Christianity could and should look like in Africa.  He hopes to take his outreach to some people-groups in the Eastern part of Kenya who have never been exposed to Christianity and don’t have a Bible written in their language (which was developed into a written form some ten years ago).  Sounds pretty awesome. . .I can’t think of a more difficult, yet more amazing undertaking than translating the Bible into a completely new language. 

The girls spent the afternoon with the Matsons. . .they found a little house (for dogs maybe??) and decided that by cleaning it up, they were cleaning up the world.  When I showed up, they had completely swept it out, sponged down the sides of the house, and were begging us to go buy paint so they could work on the exterior.  Now if only they thought cleaning our house was cleaning up the worldJ 

Prayer requests – For Arianna’s endurance and for the kids she treats at the hospital.  I was thinking today, particularly with her super-sick boy, how the prayers of people half-way around the world could change everything for him and his sweet father.  “The prayer of a righteous person is powerful and effective” James 5:16  Also pray that I could meet up with some of the guys I spent time with at the beginning of this week – I would love to continue those relationships.  

Day 4

Arianna was on call last night (which at Kijabe means she is actually at home and gets called when there is an emergency/question) and about 4 am got a call asking whether they should support a baby born at 27-weeks.  Even in the states, this would be a very, very early delivery, so she walked up to the hospital in the dark, baptized “micro-baby” and a few hours later he is breathing on his own with the help of a c-pap and receiving food through an IV.  

Ari had several other victories today. . .one patient was recovering from meningitis, but needed a spinal tap to make sure treatment was successful.  Another doctor had tried unsuccessfully and the father said "no more."  But they managed to talk the family into giving Arianna one try and she got the perfect champagne tap on her first attempt (if you're medical, she said something about 18 gauge needles and butterflies - I have no idea what that means!)  

Another patient had been sick for weeks, and she switched his medicine yesterday. . .24 hours later he is night and day improved.  All in all, Arianna is exhausted, but she is doing well!  

I spent the early part of the week helping William and Jeff cut grass in the front yard, and today a new man was out working in the yard with a couple of sacks, raking up the grass we had cut and stuffing them in.  I helped him rake and we talked for a while, and it turns out that he lives up the mountains and uses the grass to feed his cows.  He has two cows and a bull – the cows give him about 20 litres of milk each day, which he sells to the processing factory.  The bull will be sold for slaughter when fully grown, which takes about two years.  He said he works hard because he is a Christian, that he works hard for six days and then takes a rest on Sunday.  The work is to send his children to school, it costs him 60,000 shillings per year, about $1000. . .which here is a LOT of money.  Like in the states, the problem, he says, is unemployment.  Kids get out of school and, even though their parents paid huge sum of tuition money to get them through, graduation doesn’t guarantee a good paying job.  Hence my friends William and Jeff, who are very bright, but work very hard at manual labor every day.  But they do work and work hard. . .it may take 20 years for them to open up their milk business or whatever it is they will do and be successful at, but I hope they will persevere.  

As for the girls. . .we had a good day with friends again.  I'm learning that the key to climbing the mountain is a good snack beforehand.  I had all 5 for the afternoon and we snacked well and they pretty much raced the trails up to the playground at RVA. . .I would have to jog to keep up with them, and Annabelle would outrun the older ones at times!  Madeline and Sofia went on the zip line. . .definitely the most precarious zip-line I've ever seen. . .I'll take a few pictures next time it is attempted, but I realized that it was a three-adult job to work it properly.  Essentially they have to climb a series of swinging tires up into a tree, clamber on to a platform (I would have to climb up to help them with this last step - the one safety mechanism of the zip-line is that it is really hard for a kid under age 13 to make it up!!)  Then I would climb back down, fetch the rope attached to the bottom of the seat and swing it up to them.  Then another climb back up to help them get on to the seat (if you can picture it, there is a iron T bar hanging from the zip cable, with a rope coming down from the T. . .they sit on a plastic circle seat, hold on to the T, and once they are off the platform it's pretty secure.)  Then another climb down the tree to help them dismount once it stopped - they would be hanging sitting about 5 feet off the ground - they could lower themselves and drop to the ground fairly easily, but I could see why that seemed scary!  

The romp down the mountain after playing is about the most fun thing ever. . .the afternoon light is magical, there are seven jillion converging paths and hiding places, and they delight in running fast and trying to scare me from behind trees and bushes.  I like to think I'm bigger and smarter, and today I did manage to take a shortcut and scare them with my best lion roar. . .but they are very fast and sneaky - they are hard to surprise!  After we dropped our friends off, we did get to watch the sunset with Arianna finally (she's been at work or we've been at a social event every night until now) - definitely the best perk of Kijabe.  

Tomorrow is my first swahili lesson with Edward. . .when we lived in Taiwan, language class was fantastic, not only to learn to speak, but to really understand the culture and be able to ask questions an process what we were seeing on a daily basis.  

Prayers - The hospital can be exhausting and overwhelming for the doctors and their families, particularly those who have been here long term.  Please pray that they would be refreshed and that we would have opportunities to encourage and support them while we are here.  

Day 3

Sunset from our front yard - pretty much amazing!  A family of monkeys was playing in the tree on the left when we came home this evening.  They are fun, but they like to get into the trash and make a mess of the yard.  

The girls with their new friends (except for 4 yo. Esther who was taking a nap) - we went up the mountain to swing and play on the trampoline all afternoon.  Kijabe is pretty much kid heaven, it's so fun to watch them run along the mountain paths.  It is exhausting, though, a 30 minute walk uphill to the playground, doubled because we forgot to bring snacks today.

Arianna has had a killer day, so keep her in your prayers.  Apparently medicine is pretty similar except with patients in dire situations.  The treatment for shock is different and she has a child that would normally be on a ventilator at home that is treated differently here.  It will take some time for her to figure out what is best, the way she treated at home or the way it is done here. . .it's hard to figure out.

This is the crazy thing about medicine in general, there is such a specific road map for life as a doctor from college through med-school through the beginning of residency. . .then the doctors are thrown to the wolves, trying to figure out the systems.  So much of medicine is reading people, whether patients, other doctors, nurses and having the ability to filter the truth out of what has been said and create a proper diagnosis and course of treatment.  Being in a new hospital for three days, when she has years of experience with the people she works with at home is difficult. . .Arianna's greatest gift is reading people, but it comes better with time.  

As far as the Kenyan side of medicine, Ari said that she's already begun to not notice the ailments that would be bizarre to see at home.  Three days in and strange thing seem normal. . .pretty crazy.  But a tumor on the spinal cord is scary everywhere in the world, so she's asleep right now (at 8 o'clock) knowing that she may be called in at any minute to try to keep a very, very sick child alive.

Prayer requests - for Arianna - for her endurance - she is getting creamed right now. . .I can't remember her being this busy since intern year.  For me, that I might minister in some meaningful way to the guys in our neighborhood. . .which means pray that they would have yard work to do near where we are!

Habari yako?  (How are you?) 

We’re in Kijabe, which at least this week, must be one of the most beautiful places on earth.  The village -if you can call it that - sits on the side of rift valley and from our porch we can look out and see an incredible view.  As best I can tell there are people living all the way up the mountain and all the way down in the valley as far as the eyes can see, connected by some dirt roads and worn footpaths.  They say it is winter here and normally bitter cold, but this week is spectacular, 70 degree days and gorgeous winter light.  Last night I was wide awake at 2 am, so I walked out and saw the most beautiful display of stars ever. 

milky way from our backyard

The areas directly around us are owned by several organizations, the AIC hospital where Arianna works, CURE, an organization which takes care of kids with every sort of disability, Moffat Bible College, and the Rift Valley Academy which is a school from pre-school to 12^th grade that has to be one of the most beautiful school campuses in the world.  We can walk up to RVA for the girls to play on the playground or tonight where I played a bit of indoor soccer with some MK’s and RVA alumns (missionary kids = mk’s – that’s what Madeline and Annabelle technically are).  The number of people in the area is thousands during the day and shrinks to hundreds at night as people walk back home down the mountain. 

Arianna jumped right into work and as far as medicine goes, she feels right at home.  Though the hospital doesn’t look like the new children’s in B’ham. . ., she does have most medicines and machines (CT scanner, etc.) available that she would have at home, so she is able to practice in a way that she normally would and provide excellent patient care.  She is exhausted, working very long days with jet-lag, but hopefully her body will adjust soon!  Arianna, like myself, has a sense that we are on the verge of something large with this trip. . .as if we are just touching the tip of the iceberg that will be our future lives - it is very exciting, but a bit anxious as well.  

Madeline and Annabelle are happy as clams today (as they were most of the journey save for a few moments brought on by exhaustion).  They made friends with a family with three children ages 3 ½, 5, and 8, and it looks like they’ll be playing together most afternoons – they played at their house while I spent the afternoon figuring out how to get the internet working, and there are an abundance of places nearby to romp and play.  My big hope going into this month was to be able to spend lots of quality time with them, and lack of internet and car definitely contribute as we walk hand in hand wherever we go.  Their suitcase still hasn’t arrived (hopefully tomorrow), but they are okay with the several outfits they do have. 

A couple of goals I have for the trip are to learn some Swahili and get to know Kenyan natives.  There is a fantastic community around the hospital of expat missionary families and we went to a dessert last night and met many of them.  They are fantastic people, and it would be easy to make friends and spend all our time with them, but I want to get a sense of what life and culture is like for normal people. . .so I spent the morning today cutting grass (unakata nyasi) in front of our house with a machete and my new friend William.  I have plenty of blisters, but William (most people have English names and Kenyan surnames) is a great guy and enjoyed teaching me, and hopefully I was a bit of help in attacking the acre around the house.  He swings the machete much better than I do (you want a firm grip and a loose wrist. . .my wrists are too tight and I have to switch hands every few swings) but is very patient and has a wonderful smile and sense of humor.  The picture below is William's friend Jeff - he's a little more shy, but a very nice guy and they are both extremely hard workers.

Prayer requests - for Madeline and Annabelle to have an amazing month, for Arianna and I to feel settled and spend great time with each other and the girls, for God to do great things in our lives and hearts this month, for the girl's bag to turn up today, and for us to be able to serve and encourage our new friends well.