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Sunday, July 30, 2017

And July is a wrap . . . what will August bring??

The second half of July:  a pretty solid pace of the main areas of our life.  Patient care working at Naivasha SubCounty Referral Hospital, hours of phone calls/skype/meetings with our supervisory role at Serge, and hosting current and future missionaries.  So here's a little photo wrap-up of the month, from my phone.

Clinical work: Naivasha Hospital and a touch of Kijabe
In spite of two months of a nursing strike, which now threatens to drag on just as long as the doctor strike, Naivasha tries hard to stay open.  That means hiring short term contract nurses and stretching them thin, limiting but not closing admissions, which puts everyone in a difficult position.  If a patient is told to go to "hospital of choice" they often just get sicker and come back as an emergency.  We've seen many many lives saved in this strike, as the small crew available works hard.  But Friday we had one nurse covering about 25 babies . . . no surprise that some fluids didn't get given, or medicines were delayed.  Still the interns/trainees are coming, so we teach, round, prescribe, intervene, put in a line, do a surgery, order labs, overview care.  Here's the bustling newborn unit:

Baby A has nearly doubled in size from 880 grams, 26 weeks gestation, to 1590 grams six weeks later, her entire life lived during the nursing strike.  She's a sweet little miracle that would not have survived anywhere else in Naivasha.

These three look pretty cozy . . in spite of being almost two months early (32 weeks gestation) delivered by an emergency C/S after their mother developed a severe complication of pregnancy known as ecclampsia, with seizures and failing organs.  They were a little touch-and-go blue and floppy as Scott pulled them out and handed them off to me and my two clinical officer interns, but this photo was snapped at about ten minutes of age, with everyone breathing well.

And crazy enough, they were our second set of premature triplets this week.  They joined even smaller 30-week triplets whose mom arrived in unstoppable labor and delivered them naturally on Monday.  The six of them are in two side-by-side incubators (blue lights for jaundice).

There's also the usual rush of convulsing toddlers, HIV-affected families, pneumonias, TB, sickle cell disease, severe dehydration, injuries, swallowed kerosene or pesticides, hepatitis, unexplained paralysis, difficult delayed labors, breech deliveries, overwhelming infections.  And a newborn baby found abandoned inside the muck of a pit latrine covered in maggots, who is holding on.  Naivasha is a place of last resort for the desperate, a place to take a stand against evil, and a place to encourage others who are doing the same.

And not all our patient care is at Naivasha--recognizing that the strikes put pressure on the mission hospitals, we agreed to take call at Kijabe once a month through this period.  It's a treat to reconnect with our former co-workers and to refreshingly embrace a system where labs get done and interactions are cheerful.

And kids are very sick and very complex.

Serge Area Director Work
Well, photos of meetings by phone are limited here, even though that work is important.  With ten team locations in four countries, plus a former/hopefully future 11th/5th for South Sudan, we spend a good chunk of each month communicating with team leaders, reading, writing emails, meeting virtually.  We enjoy the privilege of walking alongside people who are living for Jesus in challenging places, even when that means they also deal with discouragement, spiritual warfare, miscommunication, legal challenges, difficult partnerships, mental health setbacks, loneliness for family left in the USA, brewing insecurity.  Our hearts are scattered about in East and Central Africa.  And as God draws more people to consider joining, we find ourselves exploring new sites, hosting, dreaming, helping to develop vision.  

This past week we spent five days with this lovely family whom we hope will be returning as a nurse and nutritionist for Litein, working clinically alongside the Kenyan team and teaching in the nursing school there.  Here they are by Lake Naivasha, on a walk from our home . . . 

And at Litein hospital, which it turn out was founded by a missionary almost a hundred years ago with their SAME LAST NAME (he planted this tree) . . 

While the parents and Scott and George Mixon met with hospital leadership, toured, went on rounds . . the super trooper kids and I explored four different Kenyan schools in town, and the market.

It is no small matter to move from a life in the USA to consider a life in Kenya, so we pray for God's clarity for them and another couple who was simultaneously visiting our team who works with inner city unreached people from a neighboring country.  These visits involve a lot of good Kenyan food, so here we are sharing a lunch with the Litein staff:
Lots of car hours seeing Kenyan countryside . . . 

And back to Naivasha in time to welcome our Bundi Team Leaders, who in the best Bundi TL tradition are having there second child here in Kenya this month.  Pray for a save delivery!

And the rest of life . . . 
In between caring for patients, teaching trainees, recruiting new workers, and supporting teams . . . life fills the hours left.  Shopping, cooking, walking the dog, neighbors, and family phone calls.  This blog from Serge popped up again on my facebook, and expresses well one of the greatest struggles of this season of life:  
By following God’s invitation to international mission work, we extend an invitation to our adult children and parents to find more happiness in Jesus than in the comfort of family. 
That, friends, is a difficult and inconvenient truth for sure.  Our sisters, our mothers, our kids pay a high price.  So it's always a treat when we get snippets of their lives by texts, photos, phone calls.  And when they get to support each other.  C got an unexpected and sudden week of leave because his regiment is likely to deploy soon--not enough freedom to come to Kenya to see us, and we couldn't come see him, and that was SO HARD.  But his big brother pulled him into his own life for a week, a true blessing.  Plus he sent us photos.  What a good brother.

J finished her two month internship in Jordan with a party from her environmental project coworkers:

L heads into two months of intensive sub-internship rotations in orthopedic surgery in New Haven and Cleveland, starting tomorrow.  And our youngest is immersing himself in New Zealand student life, from engineering classes to backpacking.  There was a MOMENT ON FRIDAY when we were all on a Google Hangout at the SAME TIME (L not pictured but in back seat holding the phone that shows C).  Our time zones span 20 of the 24 hours in a day, so it's no small feat (aided by the fact that a certain college student is alert at 2 or 3 am in his time zone).  

Our church provides us with community, fellowship, prayerful encouragement.  I often play the keyboard, and today Scott was asked to lead the service.

So what about August???
These are three of the little lives who would like to know (Scott's photo, at a few hours of age).  Kenyan elections are set for August 8.  The entire country is sorting itself into tribal groupings, as people return to their ancestral homes to vote,  and to ensure their safety from other tribes.  Ten years ago at least a thousand people died in post-election violence stoked by politicians.  Tens of thousands were displaced.  This cycle we read of riots, youth attacking rallies, thugs taking advantage.  There is an edge of uncertainty.  ALL OF OUR FELLOW DOCTORS (consultants, medical officers (like residents), and interns) have told us they will not work the week of the elections.  Where does that leave our patients?  Particularly with the ongoing absence of nurses?  We hope at least a skeleton crew will remain of clinical officers and short term nurses, for the sake of the babies, the emergency deliveries, the poorest patients without other options.  Please do pray for peace.  Our sermon today was from John 16.  In this world you will have trouble.  But be of good cheer, I have overcome the world.  Pray for all of us here in Kenya to see that promise of Jesus pervading the country, overpowering the evil of men.

As a bonus for reading to the end, here are the 8 paintings done by the Shirk's niece, on the wall of the Paediatric Ward at Kijabe, lovely portraits that honor the patients we care about--

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