Where is Kijabe?: frequently asked questions part 2

I've combed through the earlier pages of the blog several times this week to try to give people a better picture of where we're going, so I thought I'd put together a post that paints a picture of Kijabe a little more concisely. Some of this is repeat if you've been following closely, but other info might be new

First things first, where is Kijabe?

It's about an hour Northwest of Nairobi, the capital of Kenya. There's actually a satellite image on Google Maps if you want to see the detail. We'll be living at Kijabe Mission station, not the town with the same name about 2 km away. In the Maasai  language, it means "place of the wind" and the town sits perched at about 7,200 feet above sea level on the edge of the Great Rift Valley. You're not going to find it in any books on Kenya, because its a little collection of houses, hospitals and schools down a 6 km dirt road off the main highway, but we're excited to call it home.

What is the hospital like?

Unlike a lot of doctors in the post-residency program, we have the advantage of having been where we're going, so we have a general idea what to expect. AIC Kijabe Hospital is a 320 bed mission hospital that takes care of adults and kids that was established in 1915 (so we'll be there for the 100 year anniversary).

Here's a picture from a house when it was being built we received from on of our friend's husband's grandfather who helped found it. . . 

I didn't venture much into the adult side of things, but the pediatric side consists of  a simple and efficient concrete building with common wards, an OR, a nursery, and an ICU. It is a training hospital with residents and fellows assigned there to learn  general specialties as well as pediatric neurosurgery and pediatric surgery (giving us the amazing advantage of being able to address those issues quickly, which is no small miracle). 

We have a wonderful pharmacy, and the pathology lab does tissue diagnostics for 37 mission hospitals in East Africa

hospital entrance

ED and Maternity/Pediatric Clinic Entrance

Intensive Care Unit (this is half of the 5 bed unit)

General ward with 6-8 beds per room and oxygen on the walls in between beds

Bilirubin Lights in the nursery

Code cart that we made while I was there for the clinic

Pharmacy

Rounds with the Residents

View from outside the Children's Ward

What kind of things will you be treating?

A little bit of everything, it seems - from well newborn babies, to premature infants, to infants with severe birth defects, to meningitis, bronchiolitis, asthma, pneumonia, tuberculosis, AIDS, severe malnutrition, gastroenteritis (both bacterial and viral), heart disease of all sorts,  infections, birth defects from viruses mostly prevented by vaccines here, children waiting to have shunt placed by neurosurgery or to get healthy enough to have a corrective surgery by the pediatric surgeons, malaria (although not as much as you would think because of our elevation), and then countless other things I can't even begin to imagine. Like medicine in the states, the body is an amazing thing both in the way it manages to get sick and the way it heals. Every day was filled with surprise, failure, small victories, and constant learning. 

What other doctors will be working with you in Kenya?

When I get there, 4 pediatricians will make up the team of doctors taking care of the kids in Kijabe.

  Jennifer Myhre has been in Africa 20 years and Kenya for 4. She and her husband are American, but they carry the weight and wisdom of having created a home in Africa for so many years. She has 4 fantastic kids, and I can't wait to begin to learn from her. She's also an amazing writer, and you can probably learn more about what we're going to be doing from reading her blog than from mine. 

(http://paradoxuganda.blogspot.com/)

Sarah Muma and Imma Kariuki are both Kenyan pediatricians working at the hospital. They are both moms, wives, and amazing role models.  Imma is there now (although currently on maternity leave with her son), and Sara will be moving back about a month before us with her husband who is a pediatric surgeon.

Mardi Steere is a pediatric emergency medicine doctor from Australia who did her EM training in Florida. Right now, she's the medical director of the entire hospital, so I won't get to work with her directly in patient care at first. She was the doctor that greeted me during my meltdown at the end of my first call weekend, and she already has a knack for knowing me a bit better than I know myself. We loved our time with her, her husband Andy, and their two kids that are close to Madeline and Belle's age, and we can't wait to get to know them better.  Their blog is amazing as well, and Mardi's husband is a jack-of-all trades engineer theologian and his perspective might give you a better idea of things David may find himself doing.

(http://www.steeres.com)

Eric Hansen is the pediatric surgeon that we'll be working with (along with Sara's husband, whom he trained) - and the reason that we found Kijabe in the first place. He was a surgery fellow when I was a resident and may be one of the most generous, caring, down to earth physicians I have ever met.  4 years ago when he and his wife sat on our couch and joked that they needed a pediatrician for their kids in Kenya, we had no idea where the road would lead us. Their kids are also close to the girls ages and we are looking forward to learning from them as well. 

(http://uncommonroad.blogspot.com/)

What will your schedule be like?

Between the four of us, we will need to cover the wards, consults, ICU, outpatient, and nursery/NICU. Most days will be 8-6ish and then I'll take call  about once a week and every 4th weekend. We have some wonderful other physicians that help split call to make that possible, but as people come and go, have babies, or get sick (one of the pediatricians there now had a ruptured appendicitis last month) it will probably be bit busier than that sounds. I'm excited to be working with women that have families, and who, even in my short time there, reminded me of the importance of balance and boundaries. More sick children and more work always exist, and it will be a constant struggle and challenge to find the place where I can be mom, wife, physician, and friend with grace and joy.

Road to the market and church outside the hospital

Road to our house about 1/4 mile from the hospital

Kijabe sunset over Mt. Longonot

Okay, perhaps there will be a part three to the this post, but there's a glimpse of the next phase of our lives.

Courage

Our move is becoming common knowledge now - it seems more people know now than don't, and it peppers our daily conversations. One of the more common responses is the implication that we are in some way brave to be doing this. . . that the move involves some kind of courage. 
For me, it seems quite the opposite. I am much more afraid of who I will be and what I will do with my life if we stay where we are.  
I am scared that I would waste the best years of my life predominately in isolation, editing pictures and staring at a computer screen rather than getting out and engaging the world, building relationships, and loving my friends and neighbors well. 
 I am scared that I wouldn't create adventures for my girls, that I wouldn't teach them to climb trees or mountains, for frankly my track record hasn't been very good so far.  
I am scared that I will spend more time staring at a TV screen next to my beloved than talking and dreaming with her. 
 I am scared that we will raise children who are insulated from the needs and hungers of the world.  
I am scared that I will give the girls everything they could possibly want and then some, spoiling them and creating an idea that happiness will always come from having more.
  I am scared that I will never be a part of Arianna's work. . .that she would save lives and I would not share in that joy.  Or that she would be unable to save a little one and that I would be unable to share her grief and heartache.  I am scared that I would not be able witness her at her absolute best - healing and caring and loving.  
In many ways the promise of resolution of those fears, hopefully mixed with a bit of courage,  makes me most excited about Africa.  

 “My grace is sufficient for you, for my power is made perfect in weakness.” (2 Corinthians 12:9 ESV)

Christmas

 The past 3 days have been a wonderful celebration of family - the  realization of a new generation as our children play as old friends, and we wait with expectation for Ashley's new little girl in a few short weeks. David and I look around and we feel the culmination of years of dreaming. My sisters and I are women, with families and careers and lives of our own that merge in a controlled chaos for a few days a year to recount memories and settle into the safety of my parent's home. As we sit around the table, laughing as santa Yoda enters the Christmas story to tell Mary there is no room in the inn, we are relaxed -  and I can see the phantom of the years rolling out as our children grow and our lives settle into routines and new realities.
We are family, and it is wonderful.

But our looming reality creeps into the quiet moments and comfort of tradition - in the Candlelight Service, I wedged myself between my sisters as we sang Silent Night - and with one brain we playfully mouthed the German first verse, unsure of the words - then swung our candles side to side like we were at a concert  for the second.  The tears streamed down my face as we waited for mom's disapproving look only to see her tears matched mine. And, at that moment, a quick slap to my rear from one of my sisters sent me into peals of laughter as the song ended.

It is a Christmas of joy, of goodbyes, and of sacred moments.  I cling a little longer in hugs, and talk a little less than my family is used to, ponder the journey of wisemen and shepherd's to a fantastic unknown. . .I wonder what Emma will look like in her Christmas dress next year and what words my nephew Oliver will have learned - I wonder what 80's reference will enter the story of the Christ Child as the family retells it. I wonder and hope that there will be a place in Kijabe to find such joy and rest.

A bit of my heart is in Kenya this year, but most of it is here with family - and next year I know a bit of theirs will be in Africa with us.

Answers to the most frequently asked questions. . .

Where in Kenya are you going to be moving?

We're moving to Kijabe, Kenya. It's a small village built around a mission station established 120 years ago, about an hour northwest of Nairobi, the capital.

Where are you working? Is Arianna going to be doing pediatrics or everything?

I'll be working at AIC Kijabe Hospital (http://www.kijabehospital.org). It's a 320 bed hopsital that takes care of anywhere between 50 and 100 kids on any given day.  I'll be doing all pediatrics, all the time, but I won't just be in the ER. I'll split my time between the nursery, the ICU, the inpatient wards, and the outpatient clinic (sometimes all four in one day :)) . 

We have some big basic things, like oxygen in the wall, IVs, antibiotics, and most common medications. There are 3 ancient pediatric ventilators if we need to ventilate a kid. The needs change day to day as far as equipment, and  here's a link to some of the things the hospital needs right now. It will be very basic compared to Children's where I work right now, but it is amazing what we can still do. There are fantastic pediatric nurses there as well and a nursing school to help train them.

I'll still be teaching and will be working with some of the smartest, most motivated residents I have ever met. They train in pediatrics, OB, Medicine, and basic surgery while doing their residency, so we get to teach them as much as possible in the snippets and months we work with them on the Wards and in Nursery.

And,  what is David going to be doing while Arianna is at the hospital?

The short answer is serve.  Take care of the girls, support Arianna, and then to pitch in as needed in the community.  In our month last summer, that meant bush whacking with machetes, taking photos of the hospital and staff, making connections and friendships with the Kenyan workers, and learning Swahili.  Will I continue to be a professional photographer?  Possibly, we will have to feel it out and decide if it is fun and worthwhile or if it is too stressful do deal with the logistics of shooting in Africa. But the skills we have learned with image making over the past decade will certainly come in handy, first and foremost, to give you a glimpse into our lives and adventures!

Are the girls excited? What are you doing for school?

Ask them next time you see them - I love watching the broad smile spread across Madeline's face matched by Annabelle's shy one. They've always been pretty laid back and up for adventure. They talk daily about what they think life will look like when we move. Kids are everywhere in the village, both missionary kids and Kenyan.  It's a idyllic place to be a child, the beautiful mountainside, endless playmates, trees to climb, safaris just an hour away.  Madeline and Annabelle will attend school at RVA, or Rift Valley Academy, which is an absolutely fantastic mission school just a few minutes up the mountain from us.  The students are from all over Africa (and the world), so it will be a phenomenal cultural experience and learning environment.

Are you selling your house ? What are you doing with all your things?

Yes, we're hoping to have it on the market in March, so if you know someone looking for a great house on Alford with an attic playroom and big yard, let us know ;).  It's interesting to think about selling all of the things we've accumulated in the 12 year since we got married - but expect a big yard sale in the near future, and feel free to claim something if you come to visit. We'll be taking 8 suitcases with us to Kenya and storing pictures and more personal memories, but everything else is going to be sold before we go. I might need some extra hugs this year when I take down our Christmas decorations . . . 

How long will you be in Kenya? 

 The Samaritan's Purse post-residency program is for two years.  The design of the program is to place recent graduates in the field and give them opportunities that will pave the way for a career in medical missions.  In the latter part of the program, we will start working on a transition toward a long term sending agency.  We are committing to Kijabe for two years, but placing ourselves in a position to do this for the long haul, whether that is five years or fifty.

When do you leave?  

End of September, 2014.  We have our last few weddings booked for September, so we'll shoot those and then jump on a plane!

How can we help?  

Keep up with our journeys here. Prayers and encouragement will be our lifeblood, so please add us to your prayer list and shoot us an email from time to time!  Financial donations can be made through Samaritan's Purse or our church.  As we get closer to the date of leaving, I'm sure we'll have more specific things, but for now, keep walking alongside of us as we figure this all out. 

These changes have made us more vulnerable than we have ever been and we are incredibly grateful that you are all walking with us.

Heading back :)

When I was writing people from Kenya in July, my sister Alli replied to one of my emails with a simple question:"Why can't you actually end up there in Kenya? Sounds like they need you. Sounds like you fit in just a few short weeks." It was the question that had been echoing in our minds all week. Kijabe, in 2 weeks, felt like home. It felt like our hearts were taking root it a way neither of us could explain.

After my crazy call, I sat down to dinner. . .
David looked at me, smiled, and said:

"You want to come back."
I nodded.
"Me too," he said.

And I breathed a huge sigh of relief as I realized, that once again, in this crazy, life changing thought that I feared was too strange to be shared, we were on the same page.

It was a quiet whisper in the middle of the storm.

From that moment we started a whirlwind -  a spontaneous coffee break at Mardi's kitchen table, some pointed emails with certain pleas to Samaritan's purse, two 30 page applications, and 7 letters of recommendation in 3 days, two interviews, uncertain moments, redirection. And then a phone call on my way home from work from an unknown number in Boone only 6 short weeks after we landed in Kenya. . .

"We are excited to welcome you into the Post-Residency program for Samaritan's Purse. . ."

I'm sure things were said after that, but it's one of those moment's where time stood still and I realized the entire course of our lives had shifted -  and I was ecstatic, a bit terrified, and so grateful as another door was swinging open for us, taking us back to a place and people that we loved already. 

A couple of days ago, we received final confirmation that we have an official place in Kijabe, starting next September for at least the next two years.

David will keep shooting weddings while we are in the States, I will keep learning and soaking in every bit of wisdom from the doctors and nurses here and finish my fellowship.  And we will start preparing to sell everything we own and move to a place we cannot imagine not calling our new home.  

Stay tuned for the continuation of the adventure. . . 

-ari


After the earthquake came a fire, but the Lord was not in the fire. And after the fire came a gentle whisper. 1 Kings 19

Westgate Mall

We've been getting questions about the situation in Nairobi and I want to share some insights from our friends in Kenya right now. A big part of why we want to return to Kijabe is to have the opportunity to learn from amazingly wise people like these. . .it's like reading a textbook on how to handle, process, and work through a nightmare situation.
 http://paradoxuganda.blogspot.com/2013/09/westgate-mall.html

http://steeres.com/?p=5811

Adventures in Birmingham

Some good friends came to town for Labor Day and we went to the zoo (yes, B'ham has dinosaurs at the zoo) and the science center. Touching live sharks, watching the baby Orangutan play, hearing the T-Rex roar, it was a lot of fun.  It's easy to take for granted when we live here but Birmingham has some great adventures!

The girls are back in school and absolutely loving it. I'm a pretty laid back parent and they love having the structure and learning schedule that school provides. . .not to mention new friends and wonderful teachers.

touching sharks and rays

baby orangutan