Welcome to our trip to Africa.

Monday, April 4, 2011

Are We Heading Back to Kenya Anytime Soon?

Hard to say. I think we had a wonderful time. But it’s a really long ways away...2 days of flying, not to mention the 12h delay getting out of Nairobi and 24h delay getting out of France! Zach made such a great connection with John Njane and felt really vested in Flow of Hope and would love to see it really take off. He also was introduced to groups striving toward better farming practices and reforestation projects he could easily fall into. For me, I think part of the romance of living overseas is learning the language and feeling submerged in the culture which is hard to do in Kijabe....lots of foreigners and as Kenya was a British colony, everyone speaks English, so it was a little harder to learn Swahili than I’d thought. I also had a hard time getting over thinking the blank stares from the nurses were because I was a white mzungu (foreigner) and a woman (not the typically authority figure)...but everyone assured me it was because I was new and everyone gets blank stares when they are new. I am sure I could get over this and definitely felt like it could get better with time. However, in Kijabe most of the missionaries live in separate areas and the missionary kids attend separate schools. Understandably to a degree, but the divide was a little too much for me. Maybe a different venue would call us back. On our way home we stayed at the Mennonite Guesthouse (felt a little like coming home). Our church in Philly, Circle of Hope was an affiliate of Mennonite Central Community. All the proceeds from the thrift store Zach helped build in Philly went toward supporting MCC. Their main missions overseas are focused on Water, Food, HIV/AIDS prevention/awareness and Peace Work. We met a young couple working with the Masai in HIV prevention who seemed really awesome and got me excited about working overseas, not to mention she was toting around 6 week old twins! We feel lucky for the time we were able to spend in Kenya, all the medical knowledge gained, and most importantly the new friends we made. I am forever grateful for this opportunity and look forward to what the future holds. Thank you.

Masai Mara....A New Respect for My Mortality


“Really, Dickson (our safari driver) I don’t need to stare in the eyes of a lion, a safe distance will do.” What an adventure! Words cannot describe the Masai Mara, endless green savanna, frosted with zebra, gazelle, impala, warthogs and elephants. Not to mention hippos, cheetahs, lions, giraffe, water buffalo, ostrich, jackals and hyena at your fingertips...and the most brilliant, outlandish birds. Just breathtaking! And as our guide pointed out....the Masai. They always talk about seeing the Big Five (lion, cheetah, rhino, elephant and leopard) and the Masai being the Sixth. They just live out here. You’ll see a lone warrior just walking along.....in this absolutely wild land.


We stayed at the most beautiful safari camp....Amani Mara...the architecture was so unique and the owner a conservationist so the camp and the structures were built ecologically. We could lay in the pool and watch the hippos. The staff were so friendly and we planted three trees before leaving. Gus will have to go back one day and see his fig tree.

Here is a picture of where we ate breakfast one morning (lion pride in the bushes behind me). All was well until our guide said we should head back to the car....quickly....seeing a lion dart out of the bushes. OMG...I grabbed Gus and ran so fast. Then he called us back as the lion had turned and ran away. And it was just one lion after-all. Hmmm....one thing I learned traveling in the Mara is that there is never just one lion. There’s always a pride of lions. 


I think Dickson was playing a joke on us the first day, giving us a glimpse of our mortality. First our jeep got stuck next to a pride of lions, sheer panic....thank God for land rover power and giant tires. Once that frightening experience was over, within the next 10 minutes the jeep’s battery died, again next to the pride of lions. Of course this is when Gus decides to throw a tantrum. The lions had been sleep...then they woke up, one staring right at us. Me panicking again, “Here Gus eat a cookie.” Zach taking pictures. OMG...I never need to see another lion. The safari staff was teasing me later, saying “Katy you don’t like the lions but this is their home.” Me, “oh, I like lions, just from a distance.”












---Katy



Rethinking Medical Missions

One of the many reasons we came to Kijabe was to get an idea of what it would be like to live and practice medicine overseas on a longer term basis. I always thought this would be part of my practice in the future but have not been sure how it would all play out. I also always saw myself in a Spanish speaking country as I speak Spanish but didn’t want to limit myself and thought Sub-Sahara Africa sounded like a new adventure.

But one of the difficulties in making a long term commitment is not only language and culture differences, it’s educational and social reasons as well. You miss your friends and family. I’ve had the pleasure of working with Drs. Jennifer and Scott Mhyre this month. They are physicians who had been working in Uganda for 17 years, raising their four kids there (even through the ebola outbreak!). Scott and I had a great discussion during an hour long paracentesis while draining 5L of ascitic fluid out of a woman’s abdomen who most likely had cancer in her liver (very slow due to the tubing available). I was asking him how they overcame these obstacles of being a westerner in a foreign land. He said that through World Harvest, his organization that led him to Uganda, they went as a team with five families of close friends. He said the group changed over the course of the years but they always had a core group that stretched over the 17 years. He said it was ideal and really the only way he’s seen missionaries make it. You always have someone to hold your accountable, especially important in medicine as staying up with the latest information is daunting even in the states. It gave me an idea.....thinking about my fellow Swedes (residents) back home. Want to go together? Even cooler would be my closest girlfriends from med school, we all chose different specialties, we’d have a surgeon, ER doc, pediatrician, internal medicine doc, OB/Gyn and 2 family med docs. Not a bad team. Who’s up for it?

So "Stat" Means Do It Yourself

This post is a couple weeks late but I have composed many blogs in my head and am just finally now getting the time to post them on our 10 hour flight back home.

I literally walked into the Women’s Ward this morning to find an 85yo acutely ill woman with pneumonia with a heart rate in the 200’s. (Normal being 60-100). Luckily she was stable though requiring oxygen, mentally just fine. Knowing the monitors are not always accurate I checked the woman’s pulse and listening to her heart. It was definitely atrial fibrillation (a.fib), an irregularly irregular rhythm and quite disturbing as it was so fast. I tried to understand what was going on, asking her nurse how long she had been in that rhythm and that I needed a stat EKG. The nurse said she didn’t think the monitor was correct overnight and that she had been rechecking with a pulse oximeter which read high 90’s. I tried to explain that a pulse oximeter is a brief moment in time, not as accurate as a monitor but to be sure the best test is to feel the woman’s pulse. I think she understood and we examined the patient together and she agreed the patient’s pulse was abnormally fast. But alas, no EKG yet. We called to find out what was taking so long and were told all the EKG techs were at chapel and not available. I said...where is the machine located, I’ll do it myself. So I went and got the machine, ran it myself and then determined that yes we need some IV medications to slow this heart rate. Well, supposedly they didn’t have IV beta-blocker or calcium channel blockers in Kijabe Hospital, hum. I walked over to the ICU to find out how one corrects this problem here as surely this was not the first patient with atrial fibrillation. No attending docs were available. I knew my other option was to shock her back into a normal rhythm but I didn’t think that could possibly be the best option for an 85yo woman who at this point in time was stable, though I wasn’t sure how long she would stay that way with a heart rate that fast. Randomly, an ICU nurse overheard my questioning and said they have some IV heart medications in the theatre (OR). So I headed down there to find what I needed. Long story short, IV labetalol was available (only option), I gave it, corrected the situation and the patient did well. But what a round about way of doing it. It was good practice for a similar situation a few days later. That one was a little more complicated because the patient wasn’t already on a cardiac monitor and I had to wheel her bed into the more acute monitoring room myself. I guess “stat” means....do it yourself. Reflecting on these situations, Dr. Mhyre (a supervising doc) teases the nurses saying, “Dr. Katy is going to pull out all of her hair....how much does Martin (my counterpart) have to pay to get some assistance?” 
---Katy