Hakuna Mata

If you see some brother or sister in need and have the means to do something about it but turn a cold shoulder and do nothing, what happens to God's love? 1 John 3:17


I have already been here for one week! It has gone very fast! My last roommate, Dayna, left yesterday! Nooooo, so sad. She was so  sweet and such great company. There are some medical students from Nairobi coming, but probably will not arrive until about the time I leave. I hope I don’t get too lonely!! I’m going to have to start knocking on doors and begging people to be my friend! John, the one my brothers age who lives above me, said he would take me on their motor bike/cycle thing to Mayers Ranch where Rod and Melanie live (the other couple that joined us at Hell’s Gate). It is apparently gorgeous with a huge awesome sycamore tree and a beautiful lake for swimming! I donno about the temperature so much with the swimmage tho. We will have to see about this…

I had the privilege of getting coffee with a family medicine resident from the Seattle and two Kenyans. It was so fun. They were telling me stories of their lives! Apparently in Kenya, “talking suggestively to a girl” is only getting to know someone with the potential of maybe dating, “pleasing a girl” is flirting, and “eloping” is when you leave your residence to go stay at a house of someone of the opposite sex. The other American and I kept looking at each other during this Kenyans story thinking wow these guys are very inappropriate!

Swahili is a very fun language and one of the interns is teaching me a few new words everyday. Today I learned pain, medicine, fever, and little (uchungu, dawo, joto, and kidogo respectively – not sure about those spellings). Asante sana (which you may remember from a line in Lion King) means thank you very much and hakuna (as in hakuna mata) is Swahili – and it does mean worry so that was another word down!

Wednesday night in walking back and forth from home while I was on call the stars were BEAUTIFUL. They seem so big. I’m excited to see them this weekend out at Masai Mara (safari place).

Tonight I went to a women’s book group – we talked about a book called When Helping Hurts. It was about how Americans go to other places with their big feeling superior foot steps and just harm those in poverty because we make them feel even more inferior. We talked about how you should view places you go to as less relief and more development – provide sustainability – teach – minister – don’t just give give give making them feel more hopeless, depressed, shameful, voiceless, fearful. 10% should be relief, 90% should be development. AND do not do for people what they can do for themselves – now there are exceptions of course, but we should be asking people what they have not always what they need! Pretty cool book group!

Fun facts: 40% of the Earth’s population live on less than $2 per day, 1 billion people live on less than $1 per day, the average American lives on $90 per day --- YIKERS!

Medicine in the Bush

Dinner - Fisherman's Gate on Lake Naivasha with the Fishers, Rod, and Melanie

Cold, rainy Monday but an interesting day at the hospital. I was in surgery clinic from 8am-5pm, and our team saw approximately 60 patients. The most interesting thing was this crazy papillomatous mass on a woman’s tongue. I saw really severe bladder and pancreatic cancer and a ton of prostate and breast cancer. The horrible issue with breast cancer is that the women here are not bothered by lumps in their breasts, they are bothered only when they become ulcerated and foul smelling. One 38 year old woman was here 7 months ago for a biopsy of a 2cm mass in her breast that turned out to be infiltrating ductal carcinoma – she never followed up, but now since it is disgusting and ulcerated and smells she comes in and it may be too late to operate. Many do not have phones here so you cannot just call them up and tell them to get in because their pathology came back badly. I also saw a 30 year old with HIV who presented last visit with a CD4 count of 15 and tuberculosis. He is still being treated for TB and now has esophageal candidiasis…yikers. It is horrible how bad these patients are before they come in to the hospital. I think part of it is how tolerable they are to pain and a lot is money. 500-700 shillings can feed a family of 5 for a week. That is around $6! A culture and sensitivity costs about that much so you have to weigh the value of getting tests against food for the family. Side note: I cannot believe the speed at which these people suck down the HOTTEST BEVERAGES! I had taken maybe two sips of my

Crazy large cactus.

Monday night I was on call with one of the Clinical Officer intern which is like a Physician’s Assistant in the US. He is super bright and helpful. I got to stitch up some guys face by myself, no supervision involved, which was pretty awesome except I took so long I think the lidocaine was probably warn off by the time I finished! He was a tough guy though, and it was his face! So I wanted it to look good!! A 37 year old patient presented to us with what appears to be chronic renal failure – according to the doctors that is pretty much a death sentence over here especially if they are HIV+ (which like 70-80% of patients are) because no one will accept them for dialysis.

Tuesday I spent the day in internal medicine on the women’s ward with the CO intern, Michael, again. Dr. Lechford (sp?) was our attending, and he went to school at UTMB too! Woo hoo for UTMB. We have another really sad patient who looks like she has mental retardation but approximately a month ago was completely normal – she has TB meningitis. So so sad. I am most likely going to seroconvert on my next PPD for all the tuberculosis we see here! I watched one of the radiologists from the states do a core biopsy of a liver mass as well. He is really excited that an American company (I think Siemens) is considering giving AIC Kijabe Hospital and old CT machine that does 4 slices – in the US the most modern CT scanners used do 256 slices! That gives you an idea of how ancient and restricted this place seems, but they do amazingly well (thanks to Jesus Christ) with the little that they have.

Poinsettas grow everywhere here! I love Christmas!

So that was lot of medical talk. Sorry! More interesting blogs to come soon because I’m going on a SAFARI THIS WEEKEND! J

 A note on my sleeping: IT IS HORRIBLE! I tried not taking my sleeping medicine two nights and had the most miserable sleeps ever. My parents especially will find it not at all hard to believe that I am freezing at night wearing PJ pants, 2 shirts, my North Face jacket, a sheet, 2 knitted blankets, and a comforter. Oh where, oh where is my heated blanket!?

Haven’t had a chance to take my large, awesome borrowed camera (thanks Richard) to the hospital for cool pictures, but I will post some as soon as I can!

Oh the places we will go.

Hello my blog following friends and family! Finally starting to feel like this time is going to fly by! I must admit when I arrived I had some moments of WHAT IN THE WORLD WAS I THINKING on the way here, and the first couple days I was way out of my element BUT now I've met some people and I think I'll be home before I know it! 

Another pic of the Great Rift Valley

Zachary

Friday evening I went running up at Rift Valley Academy. I gotta take some pics of that place it is so amazing they have multiple football fields, tennis courts, a big basketball gym...my roommate said she feels bad there is a place like that amidst all this poverty and that is a pretty good way to describe it. They have a great run around the perimeter of the campus EXCEPT there is this HUGE, IMPOSSIBLE hill. I definitely do not have enough RBCs to be running up this high! My goal is to make it around the perimeter by the time I leave but that is a pretty lofty goal given it'll be at least three weeks before blood cell compensation kicks in. Anyway, Friday night I made my first fire ever! It made me feel pretty good about myself given several others had tried unsuccessfully. :) 


Saturday was a fun day of relaxation. I hung out with my roomie Dayna and another resident Beth and her child Zachary (see pic of adorable child). I then took a glorious two hour nap! After that I met my upstairs neighbors! They are two wonderful missionaries from Seattle here for a year with their son. The dad is an emergency medicine doctor, mom is a nurse but not practicing here, and son is my brothers age. Dr. Fisher (dad) told me I needed to make the most of my experience here and try not to miss cool things. So...he told me that he is going to call me whenever he is on call and has to go into the hospital or whenever he is at the hospital and has cool things going on! He said if there are intubations or chest tubes or anything like that to be done I can do them and he will just coach me through them!! Um...so cool! They then invited me to go to Hell's Gate with them today! 

Masai Warrior Tour Guide Jackson

Hell's Gate Gorge

Hell's Gate National Park was really beautiful. There is lots of wildlife on the front part and then the back part is a hike through the Hell's Gate Gorge which is full of settled silt and rocks, but when flash floods come through (like once a year) they wash out the bottom of the gorge and it is so deep you cannot walk through it until everything settles again. Apparently alot of Tomb Raider was filmed  there. Our Masai Warrior Tour Guide Jackson was telling us all kinds of stories about how mean Angelina Jolie was, but they did all think she was hot and a hard worker. Another missionary couple went with us, and they were all so warm and fun. Because of Dr. Fisher I got in on a 'resident' rate and paid only $6 instead of $25! We saw zebras, giraffes, antelopes, warthogs, and BABOONS! We stopped at a cool place on Lake Naivasha on the way back, and I had delicious Tilapia and Crayfish. Got to see more monkeys but no hippos as we weren't there late enough! On the way back we got an excellent fruit smoothie, and I bought a pineapple which is DELICIOUS. 


Back to work tomorrow - clinic day for my team. Hopefully i'll see some fun stuff! 

Hell's Gate Gorge

A ship in a harbor is safe, but that is not what ships are built for. (a quote on a picture in my living room)

All settled in...

Oh just my backyard... :) Great Rift Valley

Wednesday I was EXHAUSTED, but after a nap I went and said hello to the people at the hospital, checked out the little market by where I am living, and went exploring. The people are all so nice. On my way home I saw about 10 of the most adorable little kids playing outside who all started waving at me, of course I had to go play with them. I guess they were all fascinated with my whiteness because they all wanted to touch me.

My little friend

Yesterday was my first experience in the hospital. The OR is called "Theater" (sp?) which is kind of entertaining. And yesterday we had 9 surgeries! Nothing too exciting -- the only one I got to do most of was the skin graft which I'm an expert at by now from Shriners. Theater is much more modern than I had anticipated, actually the whole hospital is more than I anticipated...more to come on that once I get more accustomed. Oh and mdazis are the greatest thing EVER -- they kind of remind me of Sopapillas. I guess they are Kenyan donuts, but I got one free here with some tea in the gorgeous doctors lounge overlooking the valley. 

Kijabe Hospital

Last night one of the missionaries had me over for dinner. She is from Boston and is an internal medicine resident working here in the ICU. She has an adorable little 15 month old boy that her and her husband adopted from Rowanda. We had some delicious food that the lady who watches her child and cleans her house made for us - oh, and an amazing fire since it is a little chilly here at night. She is taking me tomorrow for delicious blueberry pancakes at the Rift Valley Academy which is apparently a pretty fantastic school where all the African missionaries send their children. We are going to church there on Sunday too. 

Village/Masai Market

As it turns out, my surgery team is off on Fridays and on the weekends -- and so far I am not on the September call schedule so I have the whole weekend off for Samantha time. Today I went with my roomies to the Masai Market in Nairobi. I am fantastic bargainer if I do say so myself. My best bargain was probably a souvenir that the man said was 2800 shillings (approx $35), and I ended up getting it for 400 shillings (approx $5)! 

I guess it's time for a nap... and maybe a jog. 

My roomies Esther and Dayna

Finally made it to Kijabe!

The Serpentine

Hyde Park

Underground at Regent's Park

Big Ben

Another pic at the Serpentine

AIC Kijabe Hospital

My Home

I'm here...and soooo jet lagged! Spent 8 hours in London killing time. The first site I saw when I stepped off the tube was H&M which was basically heaven before me (girls should understand). I was going to go to the zoo which when I arrived I found out was approximately $45! So, since I'm planning to go on a safari in Kenya (um...a million times better than the zoo) I took a walk through Hyde Park and sat by the Serpentine sippin' a vanilla latte. My first class flight to London was never so appreciated until my overnight flight from Amsterdam to Nairobi which was MISERABLE. No sleep, neck cramps, small seat, mushy green beans -- and the two people next to me wouldn't stop smoochin'. Arrived in Nairobi at 6:10am (8 hours ahead). First thing I noticed -- it looked like a desert and traffic is BIZARRE. There are no lanes! We almost got in like13 wrecks. I went to a mall, pretty modern place, bought a modem for my internet so I can skype and blog away, a simcard for my phone (which I discovered when I got to Kijabe will only work in Kenyan phones...still haven't solved that problem), groceries, and some flip flops. Arrived just a bit ago at my Kijabe home where i'll be for the next three weeks -- which is only on the edge of a GORGEOUS valley, no big deal. :) I'll try to post some better pictures later. There are three girls here that I am staying with, two are leaving this week. Only one of them is a medical student like me. She is from the UK and was telling me about how much I will love this place. She said her first night on call she was the only 'doctor' in the hospital from 5pm to 8am and in came a gun shot wound among other traumas. If that doesn't make me scared out of my mind I don't know what will. There is always an intern who is second on call in case I need them...which I will. I'm so nervous! On call, by myself, with acute abdomens and heart attacks!! Uh...I really should've brought some reference materials. Okay, i'm off to try to get a hospital orientation, take pictures of the valley, and then catch up on some sleep.

Leaving TOMORROW!

Jioni njema rafiki (that means 'good evening friends' in Swahili)! I was planning to email everyone with updates while I was gone, but then Megan suggested I start a blog. I liked that idea! Hope you all will tune in for my adventures in Africa!