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Thursday, December 12, 2013

More seasonal signs: graduation, strikes, rain, Jamhuri, and cookies

December in Kijabe means rain, steady dripping cold rain punctuated by torrential downpours.  Sticky mud, sopping laundry, footprints across the floors, chilly nights.  Back and forth to the hospital in soggy shoes.  No sun.  The people that walked in darkness . . . becomes more real.  We are waiting for the hot dry wind to blow in, just like we used to in Bundibugyo. Waiting for light.

Last week I learned an important lesson:  Kenyan University Graduations are not for the faint of heart.  I had committed myself to attend Bob's, as a gesture of appreciation, friendship, and support.  My departure was delayed by the 6 am-ish appearance of a very very small preemie (660 gms) who needed intubation and surfactant and a central line, all procedures I happened to be the only one around to do.  But as I headed out, I texted and found out the ceremony had not started.  Great.   I made great time towards Thika (which is about 1.5 hours away) until a few miles out of town the six-lane highway slowed to a standstill.  Must be an accident, I thought.  But as the minutes ticked on, and on, I wondered.  I rolled down my window to chat with my neighbor struck-drivers.  Everyone around me was wearing suits and ties, and headed to this graduation.  The car next to me said to follow him, and he tried to get off for an alternate route, but it was just as plugged.  So we inched forward, literally.  It took about 3 hours to go less than ten km.  It seems that the university was graduating multiple years of students in multiple schools, and a single small road led in, absolutely jammed with thousands of cars.  I should have walked.  The next day my clutch quad was so sore I could hardly move.  At the three-hour mark I did finally park in the mud off the side of the road, and join the throng of pedestrians.  As per my odometer, the university should have been 1 km away.  But it was more like 3 or 4.  I walked and walked.  There were bodas and bodies.  People selling tinsel garlands and garish signs to place around the necks of graduates.  The crowds became so thick that walking was nearly impossible, and I still could not see the gates.  I called Lilian, Bob's wife, to say I had given up, and just then a man walked up and said "Dr. Jennifer?"  It was Bob's brother who had come to find me (not too difficult as I saw NOT ONE other white person in the thousands and thousands).  He body-guarded our way through the throng to the gate, where Lilian was standing.  Bob came out from the ceremony and I said congratulations.  I think it took between 5 and 6 hours to get to that point, and I had to turn around within minutes to get back (on a boda, weaving through cars and people on and off the road . . but that's another story).  I do love Bob and Lilian.  But I have to say I'm hoping Yale is a bit more organized in May.

Then a weekend of call, and what a call.  I kept a tally and was physically IN the hospital 26 of the 48 hours, besides phone calls.  The tiny 660 preemie thrived for almost two days, then crashed.  A toddler to whom I had grown attached, perhaps because it is December and his name is Emmanuel, died, a slow dwindle from an unexplained failure of his liver.  At one point I was masked and gowned putting a sterile line into the next preemie, then running up to resuscitate Emmanuel, then back to be sure the preemie was living, etc.  Thankfully I have a very cheerful Paeds resident from the States visiting for 2 1/2 weeks, and all the admissions and deaths and births and decisions are less stressful with company.

Then on Monday, we were greeted with the news that the entire medical community in Kenya was going on strike: doctors, nurses, pharmacists, lab techs, etc.  We were told to brace for the onslaught.  Seemingly overnight maternity began to burst at the seams--beds in the halls, in the nursing station.  Babies crammed in every corner.  By mid-week we were so desperate for space I pleaded with the hospital admin and got permission to turn the ICU room one into a satellite NICU--I fit four cots/incubators in there instead of one adult bed.  Triage and priorities, how to maximize life saving potential.  It seems that a December strike has become sort of normal.  Kijabe thankfully this time negotiated that our interns would NOT strike, so at least we are functional, just overwhelmed.  The bright side is that this week I have the biggest team of the year--3 visiting consultants and a resident, plus my colleague survived preterm labor long enough to come back to work.  All that help melts away over the next ten days, but for now the timing is good.
And as the doctors called their strike, the rest of Kenya celebrated 50 years of independence today.  Parties, speeches, and a holiday.  Which is why I only had to work a bit over two hours this morning and then came home, the first day since our kids got out of school that I've been (mostly) here.  A well-timed holiday, time to bake and decorate cookies with Jack and Julia (and a friend who had NEVER decorated a Christmas cookie in spite of living in this semi-American enclave most of his life), and even carol at a couple of neighbors, join friends for dinner, and a community Advent.  I suppose most of that didn't have much to do with Kenya's independence, but I can say the time off endears Kenya to my heart.  Perhaps Christmas Cookies and Jamhuri Day will always go together for us now.
And so December rolls on. We work, the kids sleep in, work out for next season's sports, plug through mounds of assigned homework for AP classes, watch football, and rest up from the long term.  I have a nagging guilt that I didn't come up with a plan that is unique or enriching or noble or anything at all other than hanging out at home, but I just have to trust that we're doing the best we can.  

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