The last three days we’ve been at another historic mission hospital on the eastern slopes of Mt. Kenya, founded over a century ago by Scottish Presbyterians. Chogoria is the site of our newest Serge Kenya team. We were asked to recruit doctors there to support the Kabarek University Family Medicine Residency Program. Relatively few doctors in Kenya have the opportunity to go on for a “master’s” degree (residency) after their internship. Yet these young men and women, after a 5-year post-high-school combined university/medical degree program and a 1-year internship are expected to manage all-comers at hospitals, from an ectopic pregnancy surgery to outpatient diabetes care to critically ill newborns to a hernia repair. It’s a lot to expect, so the Family Medicine residency here (unlike the USA which is more outpatient and primary-care oriented) gives the trainees four more years of mentored experience and intensive discipleship to prepare them with the skills and character to lead in managing a district-level health team as hospitalists and administrators.
In Chogoria we collaborate with the Presbyterian Church of East Africa which has hired some solid Kenyan consultants in Family Medicine, Surgery, and OB, and the World Gospel Mission who sent an Emergency-Medicine trained former-military couple to lead the team (currently on a year’s sabbatical). Our Serge contribution consists of three more families: Jason B (med-peds) and Ree’l (business and admin); Derek W (PA) and Lauren (nurse); and soon-to-arrive Larry S (family med) and Beth (lawyer transitioning to advocacy work within the church). Our team teaches not only the residents but a couple dozen clinical officer (PA) and medical officer (doctor) interns, plus two recently-graduated doctors. They provide patient care, supervise rounds, prepare lectures, ponder protocols, trouble-shoot equipment, help with budgeting and quality improvement, reach out to the community in Bible clubs, and generally model what it means to be a follower of Jesus in the context of the needs in a small town in rural Kenya.
This work grew out of the trip Scott, Jack, and I made to Chogoria a year and a half ago, with our team on the ground now for less than a year. So a visit this weekend was an opportunity to witness the early stages of collaboration and to encourage our young team members. Thanks to Karen M they spent their first few months in the same Swahili program we are currently using, enabling them to bond with the culture and place and lay a foundation for relationship. Some of the very deteriorated housing has been rehabilitated to the level of livable. Now they are into that sticky phase of plunging into all the beauty and dysfunction of a rural hospital in a poor place.
The highlight of the time was definitely just connecting with the families. If being a team leader is a bit parental (in the healthy sense of leading, setting direction, fostering the gifts of those we led, lots of meals and late night talks and trips and fun, daily presence, being responsible/blamed, etc.), being an Area Director affords the taste of the grandparental life stage. We show up intermittently bearing a few gifts, marvel over cuteness and growth, get hosted and served meals, listen and pray and offer perspective and praise, then try to direct some resources where needed. It’s actually pretty fun.
Church, a picnic by the shared neighborhood rope swing, an afternoon prayer time for God’s work in this place, dinners and evenings with each family, hikes into the forested ravines, and then hospital rounds and meetings. It was a “Choglorious” weekend (Lauren taught us that adjective). And by Choglorious, we don’t mean perfect. There are bumps galore. Interns who so want to be helpful and positive that they may think or wish they checked a lab or did a history when in actuality they are making it up. Antibiotics that aren’t given, machines that are broken, labs that are unreliable. People whose plans change, who leave or never show up. Salaries that aren’t paid. Theology that veers dangerously towards the “health and wealth” heresy. Yes, this team has some serious work ahead. It's a climb steeper than the actual physical rock scramble (note all the kids on backs) we did Sunday afternoon.
So what does “Choglorious” mean? I think it takes the word “glorious” and gives it a Swahili relative prefix, “cho”. Meaning, glory in the relative position of the here and now. Glory that God is working in the dust of Kenya. The glory of preemie twins basking in the warmth of an NICU that looks almost more biblically stable-ish. The glory of a worshipful voice in spite of a static-laden microphone. The glory of thriving children whose friend and activity horizons are rather limited. The glory of a 17-year-old AIDS patient who landed in a bed where a caring and competent med-peds doctor will think through his care and give him the best shot at survival. The glory of collaboration, imperfection, tiny steps towards quality improvement. The glory of the word made flesh, right here in Chogoria.
(A few more fun photos, from several of our phones):