First week at Tenwek

It has been a week of work both for me (Eric) at the hospital and Jodi at home teaching the kids. We have adjusted well I think and are enjoying ourselves. The first day was hard to get much done at the hospital because an elaborate greeting is needed for everyone I knew, which was the majority of the hospital staff. There is a three stage handshake, hugging on each side of their body, then asking about family and such. It was kind of bad that I couldn't remember more names, but even worse on day 2 when I couldn't remember who all I already greeted. It is bad form to go through a big greeting 2 days in a row!

I was assigned to the Medical ward, which consists of 1 large room for men and 1 for women. There are about 20 beds in each room and, unfortunately, about 25 people in each room. So they just hop on in with another sick patient and cuddle up for warmth at night. The people with fevers are the warmest, so if you get one of them you are lucky (the ones that are vomiting aren’t as good).

The illnesses vary greatly from things we see at home like strokes, pneumonia, and skin infections, to more African illnesses like malaria, meningitis, and tuberculosis. Then there is a whole slew of folks that we simply don’t know what they have. They tend to slowly dwindle to death as we continue to be clueless of how to help them. The medical floor averages about 1 death per day, but there were three over the last 24 hours. We are really struggling to keep a 21 year old college student with rheumatic heart disease from being number four.

We estimate that 40-50% of the patients have HIV. The prevalence of HIV infection in our area as a whole is about 7%. This makes winning the battle against whatever illness they have difficult.

It looks like Tenwek has pretty good OB coverage, so I don’t know how much of that I will do. That is where all the exciting stories come from, so you might just have to read more boring stories this time around. Perhaps I will just make up a few good stories if I run out of interesting material (perhaps I have already hit that point).

The kids continue to be enjoying themselves here. Our 2 next door neighbors have 3 girls that know English fairly well. They are the kids favorite playmates, which is amazing since Nathan has been in a “No girls allowed” phase (to the point of writing it ON his bedroom door with a marker before we left, by the way).

Speaking of Nathan, he was the first to succumb to the stomach bug. But in true Nathan form he felt like he was going to vomit in the morning and was eating burritos by lunchtime. Friday night the bug hit Eric. He completed rounds in the morning and slept most of the afternoon. He, on the other hand, is staying as far away from burritos as possible.

Yes, we eat burritos here and just about anything else we want. The only difference is that you have to make everything from scratch. So for burritos, for example, you soak dried beans overnight then cook them forever the next morning. We live very close to the butchery, so we hear our hamburger bellowing in the morning, and could be eating him for supper. The tortillas are rolled out and cooked on the stove. The salsa and guacamole are also made from scratch of course. So although it is more work (partially done by hired house help), the end product is fantastic.

The fruit has been delicious and we have been eating everything mango since they are wonderful right now. Mango on cereal, mango smoothies, mango salsa with fish, mango juice, homemade mango jam, and just plain mangos. Other fruits that we have plenty of are papaya, pineapple, and bananas.

Things we miss? Walnut Creek Cheese accessibility. Dutchman pastries. Of course, friends and family. This morning Julia curled up on Jodi's lap, in tears because she misses Furbee, our dog, among other things associated with home. Both kids have felt overwhelmed at times because of all the new people, different schedules, etc. But overall, they seem to love it. They have instant friends next door, Eric is home for lunch almost daily and even was here this morning some to read geography to them...fun. And what could be better than spending most of the day with Mom - in school, during recess and all afternoon? We're all enjoying this time together - away from cell phones, long-term responsibilities at home/work, etc. It's good to really get away from everything for a few months...that way we'll appreciate home and responsibilities in a new light when we do return.

And by the way, we got our toilet fixed.

So far, so good.

Arrival at Tenwek

Our trip to Kenya was great. Just like last time, the kids did beautifully on the plane because of the individual TV screens for each seat. The only way we could get Nathan to sleep, eat, or use the restroom was to turn it off momentarily. Every now and then I had to hit pause just so he wouldn’t drool from lack of remembering to swallow. I am quite certain that Nathan could have undergone a major surgical procedure without noticing.

After 24 hours of travel, we finally arrived in Nairobi. I realize that everyone THINKS they pick the slow line, but we indeed DID pick the wrong line to get our visas. After over an hour of waiting, we were the only ones left in the previously crowded room. Our kids were grumpy, but not as grumpy as their dad. The good news was that once we finally made it through, it was easy to find our luggage since they were pretty much the only ones on the luggage carousel.

We were picked up by a van driver who thankfully didn’t give up hope on us. Sometimes they scrounge up a car seat or two for the kids, but not that night. As a matter of fact we could not even find seat belts. As we raced down the road, I had to wonder why our driver insisted on driving 15 feet behind the car in front of him. Perhaps it was because he couldn’t see them since many of the cars had no tail lights! Needless to say, I wasn’t feeling very safe . . . but we’ll get used to it.

We stayed with our friend in Nairobi for a day to recoup and get some groceries before heading to Tenwek. The 3 hour van ride to Tenwek was fantastic. We have never seen the Kenyan roads nearly so smooth. Apparently the quality of the roads is improving in Kenya, although for the last 25 years there has been almost no road expansion in spite of a ballooning population.

On the way to Tenwek the kids were happy to see baboons, gazelle, and a couple giraffe alongside the road.

Once we got to Tenwek we were completely humbled by how warmly we were welcomed. The door had welcome pictures from some 5 year olds anxious to meet Nathan and Julia and our house had cards, gifts, flowers, and lots of food treats. We were greeted by many old friends as well as from many newer people that we did not know but soon will.

Our apartment is bigger than last time which is nice since Jodi will be homeschooling the kids in kindergarten. The apartment is very simple, but all we need.

We are tempted to complain about some small things, but soon catch ourselves. We were a little down that rainy season just started here. That means it will rain every day, making it harder for the kids to play outside and making it very muddy. But it also means that we will have more electricity, which has been off a lot lately because we get our power from a hydro-electric dam on the compound. (Not to mention the more important fact that farmers can grow food after a long dry season.) We were a little down that every time we flush our toilet, a half quart of water runs over the bathroom floor. But then again, how can we complain about running water (albeit “running” across our floor).

The kids are enjoying their first days of summer. There is a nice mix of American and Kenyan kids everywhere. So Julia and Nathan have been playing outside pretty much nonstop with not more than one ball and one Frisbee (but lots of trees, sticks, and critters). We took our first hike, our favorite Tenwek pastime, and got drenched 200 yards from our home. When it rains, it rains hard.

So far, so good. Work starts tomorrow.

Back to Kenya?

Here we go again! We are beginning to make plans to return to Kenya in Mar/Apr/May 2011. It doesn't seem like it will have been almost 3 years since we were last there. Since that time, the kids have started kindergarten, we've added a dog to our family, Eric turned 40 and we celebrated our 15th wedding anniversary! My how time flies when you're having fun!

We are excited about returning to Tenwek Hospital and invite you to join us as we blog our way through (hopefully with better internet this time). Our tentative dates are to leave mid-March, returning after Memorial Day weekend.

Final images in Kenya

Our last week in Kenya went by too quickly. We visited several families that had invited us to their homes. We walked about 3 miles to Peter's home, after heavy rains, so we walked through lots of mud and arrived tired and dirty. The kids held up well, after walking a long distance, meeting new people and in need of a nap. Shown in the following two pictures are 1) Peter's baby daughter and 2) Peter's mother.

Peter's family seemed to grow suddenly when the camera was produced. He, his wife and three children were gracious hosts and we appreciated the time we spent at their home.

It's impossible to travel all the way to Kenya and not take advantage of the wildlife on safari. After many weeks of not traveling in a vehicle, much less leaving the Tenwek area, we traveled over 2 hours to Mara Safari Club, on the banks of the famous Mara River. We stayed in a tent at a bend in the river (complete with a bathroom), serenaded by lazy hippos in the water during the day and wild animal sounds at night. It was quite the experience for the kids! We took two game drives each day - one in the early morning at 6:30 and the other at 3. The views were breathtaking, along with the many animals we saw. Julia's favorites were the zebras. Nathan enjoyed the giraffes and rhinoceros. Eric claims the warthogs were his favorite. Me? I enjoyed every single minute with Eric, the kids and all the animals. Todd and Cindy joined us - what fun we had together.

Hippos - what amazing creatures! I think God's sense of humor definitely shows when you watch these creatures interact with their families in their natural habitat, along with their loud grunting/snorting noises and excessive amount of flatulence.

By the end of a long game drive, Nathan was not always interested in the animals...so we took along some books. I had to pinch myself as we were so close to the two lions in the background...and all he wanted to do was read.

We traveled from safari to Nairobi for a half day of shopping and city life...very hectic city life.

In Nairobi, we visited the elephant orphanage and the Giraffe Center. At the elephant orphanage we were allowed to stand up close to the baby elephants and the kids could even touch them. The sounds they made and their funny way of walking impressed the kids (pictured along the rope line on the right in sunglasses, the two shortest people wearing hats).

At the Giraffe Center, we were allowed to feed and pet the giraffes. They have long, sticky tongues and can actually cause damage with their large, heavy heads if you get in their way.

After a few hours in Nairobi, the kids were exhausted.

Next, we headed to the beach for a short vacation before heading home. We stayed in a home with 10 of our friends from Tenwek. It was a great way to relax and unwind from the previous weeks of work at Tenwek. Lamu is an island off the coast of Kenya. The Island is Muslim with heavy Arabic/middle Eastern influence. The beach was beautiful, the water was warm, and the kids enjoyed every waking minute.

The streets of Shela Town are narrow and the buildings have many floors and intricate carvings. Lamu is famous for their carved doors and unique architecture.

For our kids, Lamu is famous for donkeys everywere.

We had a little time for shopping. Kikoys (woven fabrics) are popular here - worn by men and women alike.

The kids enjoyed swimming in the ocean. Nathan was anxious to learn how to snorkel with the flippers.


We took a dhow ride (old fashioned sailboat) at sunset and enjoyed a fantastic evening.

Our time in Kenya went by quickly, overall. We returned home on Nov. 5 after many hours in transit. When we left, the August heat was creaping up on us. When we left, our trees were full of green leaves and our perennials were in full bloom. When we left, Nathan and Julia were both wearing size 8 shoes and 3T clothing. When we left, we were in the middle of a heated election campaign. When we left, the economy seemed strong...

All that has changed. We now are bracing for 40 degree weather in Ohio. We now have bare trees surrounding our house. (Luckily, we did not have to rake leaves our first day back as the Berlin Mennonite MYF and sponsors left us with a perfectly manicured lawn the day we returned home---many THANKS!) We now have to scramble to find bigger shoes and clothes for the kids plus take into account winter weather and the need for snow pants...who has time to shop now? We now know who our next President will be. We now are in a recession...

Times have changed, and so have we. We had many hours on the flights and drive home to process our time in Kenya (in addition to while we were there as you read from previous blogs). It was a great trip, great experience. Would we do it again? Absolutely. Any regrets? None.

As we return home to our family and friends and regular routine, we hope to continue to process our time in Kenya and apply all that we learned while there to our lives here. Many will ask/have asked about our time and we'll have various responses as the days go by and we become further removed from the experience. Forgive us if we give you more information than you need or want to know...I'm sure we'll continue to be excited to share with others about our time.

Returning home - we already miss our friends back at Tenwek. The kids too talk about the friends they made and wonder what they are doing different times of the day. Life did seem simpler there at times...more difficult at other times. In the end, we are happy to be home. Very happy to be home. It's reassuring to return home and feel complete, utter happiness. We never felt UNhappy being away from home, but there is a unique feeling about returning and knowing that this is where God wants us to be...in between our times in Kenya.

Those are my reflections for the moment. Thanks to many for your thoughts and prayers. We have felt welcomed home in many ways already- from the perfect lawn, to freezer meals and groceries, to offers to help in any way as we reenter our lives here in the U.S. Home. Life is Good.

Jodi

Church Letters

KEEPING YOUR HOPE WHERE IT BELONGS

A 60 year old man recently came into the Tenwek ER with his family because he had been confused over the last month. They had been at another hospital for a couple of days, but there was no improvement. When the other hospital told the family that the man needed a lumbar puncture (spinal tap), they decided to transfer to Tenwek.

Tenwek has a good reputation and the family was willing to travel a long distance to come for care. I told them that in fact, doing a lumbar puncture was exactly what he needed. I did one and ran a bunch of other tests. The only abnormality I could find was a probable mass in the center of his chest on chest x-ray.

After several days in the hospital, we were unable to improve his symptoms. We discharged him and told him he needed a CT scan of the chest and head, something we do not have at Tenwek and something that was probably out of their reach financially. The following day the patient remained in the bed along with a family member. They told me that they could not leave because he was not better yet. They were still convinced we could cure him.

They had so much hope in Tenwek. We were unable to deliver. Although my pride was hurt by this fact, it reminded me that we will eventually be disappointed if we put our hope in anything other than God.

Here in Kenya they seem to put a lot of hope in God. Why? Because most have little else to rely on. As subsistence farmers they live harvest to harvest. There are no financial savings. If there is a drought, they go hungry. If someone gets sick, they either die or they go into major debt by going to a hospital. If one of the adults dies, which is very common with AIDS here, the rest of the family suffers from lack of income and food. Something as small as a bicycle breaking down or a cow becoming sick, can be a potential disaster for an entire family. The people of Kenya do not have much choice except for putting their faith in God.

Contrast this to us in the U.S. In fact, we do a pretty good job of safeguarding ourselves from disaster. Our impressive military seems to protect us from the ever-present fear of terrorism. Our savings can buy us out of a slow year of work and a hope that we will have an easy retirement. We have insurance for health, home, cars, life, identity theft, our dog, and everything else we can be convinced to worry about.

But in fact these things are not as trustworthy as we assume. 1 Peter 3, says, “In his great mercy he has given us new birth into a living hope through the resurrection of Jesus Christ from the dead, and into an inheritance that can never perish, spoil, or fade – kept in Heaven for you . . .”

We consider ourselves lucky to be born with all the wealth and privileges that the U.S. has to offer. But this “privilege” can also be a curse. It is often a stumbling block for keeping our hope rooted where it should remain.

In what do you put your hope? Let us remember, that ALL can be lost except that which is Jesus Christ.

Is pride the root of poverty?

I have to ask myself why so many people suffer from poverty, while the minority rest of us go on living as we do.

When we hear stories of poverty, watch movies like Hotel Rwanda, or get a glimpse of the news, we feel sympathy for those suffering. But what is it that keeps us from acting on that sympathy. Is greed the issue? Is it self-indulgence?

Perhaps it is my Amish background coming out again, but my take on it is that it is mostly pride.

If we were truly humble, we would view every other human as just as important as us. In turn, we would be unable to watch the news, feel bad for 30-40 seconds, only to go back to our life as usual. We would be unable to keep from seeking out the bad news in the World instead of avoiding the boring news of yet another drought in Ethiopia. How many people are starving to death over there? I personally read it, but I can’t even remember.

How do all of us respond when we see the stock market tumble or fuel prices go up? We each look at our portfolio and worry about our future. But do we spend even one minute considering that the wealthy nations may stop sending aid to impoverished nations because we can no longer afford it. Do we consider that the rise in fuel and food prices have more than doubled in places that people were just scraping by (but can no longer scrape by).

Many of us would like to do something, but think the “problem is too big”, “there always was and always will be poverty”, and that corruption and lack of motivation of those in need make the problem impossible to treat. But the problem of poverty is curable. Read, The End of Poverty: Economic Possibilities for Our Time, by Jeffrey Sachs, or any of Ron Sider’s books such as, Rich Christians in an Age of Hunger. In order to help poverty we need to understand the issues and know what we can do to most effectively help the problem of poverty.

There is hope and, in fact, there has been much improvement. It is possible that the problem of poverty may be solved in the decades to come. The question is whether or not each of us will be a part of the solution or continue to support the system that keeps ourselves protected.

Food Series

We'll be the first ones to admit that food plays an important role in our lives...in fact we've planned vacations before based on what type of ethnic food we enjoy. Many of you have read "The Five Love Languages". Good book. However, I believe the enjoyment of food could be considered a sixth... Now what kind of parents would we be if we did not pass this rich heritage of culinary enjoyment to our kids? They are quick learners as you can see.


Chai Time. An obligatory break in the day at 10 am. The entire compound, including the hospital, stops every morning to take chai - a very hot, sweet tea. In fact, if you stop in somewhere to do business around 10 am and they've started taking chai, you will offend them if you do not join them. So - we drink chai. Chai does have caffeine, so the kids drink a modified version called "chocolate chai" - weak chocolate milk. Now this is a practice we started here in Kenya and it will stay here in Kenya. Their morning snack used to be a piece of fruit and a cracker or two. Now it's fruit, chocolate chai and some biscuits or mandazi. Mandazi is like a donut without any sugar or frosting. Delicious and totally unhealthy. Only in Kenya!



The kids don't always know what these Kenyan kids are saying, and vice versa. But they all understand Chai, a universal language.




Speaking of food, the kids had a sleepover at our place with Anna, whose parents were gone overnight. We baked, decorated and ate lots of cookies. This was the first sleepover for our kids...and for us. It brought back memories of staying up late and talking, giggling, jumping around the room. They all did well - Eric and I are the tired ones.

Eric's on call this weekend. The hospital is busy these days. There are lots of visiting doctors, very few long termers. We're enjoying our time here and feel blessed by the many we've been in contact with here. As I've said before, time is going so fast. We spent so many months planning this trip and looking forward to it. Now it's finally here and going by too quickly. We received a number of letters last week giving us detailed updates of happenings in Holmes County, which seems so far away right now. Even though we're only here a few months, I think we'll have quite an adjustment when we return. But in the meantime, eat and be merry!

Jodi

Medical Perspective

It is amazing what we get used to.

I gave a tour to an American physician’s assistant today. I showed him our pediatric ward. He was amazed to see an 11 year old boy with tetanus and a 17 year old boy with rabies. Even the meningitis, TB, HIV, malnutrition and malaria were things he had never seen before. It struck me that what was originally so amazing to me is now commonplace.

Death has also become commonplace. There is a Family Medicine resident here right now that I thought was going to pack up his bags and go home after 2 of his first few c-sections turned up with dead babies. I received the babies and tried unsuccessfully to resuscitate them, but was not effected in the same way when they died. When the resident asked me how the sickle cell kid he admitted the night before was, he was almost crushed when I told that he had died. There is another visiting doc here now that was beside himself with the death of patient from hepatitis on his first day here.

These people got so upset that I actually had to laugh at them. I can be so comforting, you know.

But they have rightfully kept perspective on how important these people are. They are no less important than you and I.

Do we really believe it?

Weekend off

Business as usual for the kids. They are still exploring, trying new tricks, eating new foods. Life is good. Julia has just recently asked "when are we going home"? And they talk about Ohio a little more often now. I think they are most excited about riding two airplanes home and all the videos they'll be able to watch. But it's hard to explain to them that we still have a few weeks here in Kenya...what does a few weeks mean, Mom?

In the meantime, let's have fun.

The kids are becoming expert tree climbers. They have a new close friend, Anna White with whom they spend many hours. Together, the three of them climb the "giggle tree" - a popular tree in the middle of the compound. It is named appropriately, as you can see.

It just so happens, the girls have the same t-shirts!

Anna's family owns a trampoline. We usually head there in the mornings, to avoid school kids. The kids enjoy jumping and playing "Duck, Duck, Goose".

Nathan found his first chameleon near our apartment. We transported it to Anna's house in his Croc, trying carefully not to drop it. Three year olds aren't the most steady-handed. But it survived the trip. The kids said their good byes and we released it. Then they continued jumping.

Eric had the weekend off, so we took advantage of the time to visit some Kenyan friends. Geoffrey and Lydia Musyoka, with their children, Dorcas, Elizabeth and Asante, invited us to their home on Saturday for lunch. They served a traditional meal and we enjoyed spending time with their family. The kids were a little hesitant at first, but ended up eating a big lunch and enjoyed playing with the kids. We had to leave in order for the kids to take naps, and they were a little disappointed. But they slept well!

On Sunday, we visited another family and ate another excellent meal. Typical fare is rice or ugali (like cream of wheat but not creamy at all, can be eaten with fingers), greens, chapatis (like flatbread or tortilla), and some sort of beef stew or pea/lentil gravy. Pineapple is usually served as "dessert" - according to most Kenyans, our desserts are too sweet. Our feast on Sunday had all of these items - what a treat.

Monday is fast approaching. Eric will be busy this week and is on call 4 out of the next 7 nights, including the weekend. More visiting doctors have arrived in the last few days, so coverage seems to be getting better, except in pediatrics, where Eric will spend most of his time. This week we'll probably visit Anna, jump on the trampoline, play with Emma the dog and just have fun!

Thanks for your continued thoughts and prayers. It's hard to believe we're almost half way through October!

Jodi

Why is life so complicated? (Eric)

Life here at Tenwek is simple and good.

I am on call for 4 of the next 7 days. But this week I know I will have more time to go on hikes with my family, more time to eat with friends, more time to read, and more time for just plain silence, reflection, and prayer than I would at home.

Life here is simple. We walk to work, work hard, and then come home. There are no meetings, no paperwork, no soccer games, no going out to eat, no TV, no sitting in traffic, little shopping, no chatting on cell phones, and almost no bills to pay. We haven’t been in a car for over 2 months.

We're beginning to sound a little Amish. Through this time, we are learning the value of the Amish mentality of keeping things simple. I may buy me a hat. The American way of being busy can be our enemy. Although the things we do with our busy schedule may be valuable, they deter us from the more important things in life.

Apparently, we do have a choice.