April: a sip from the deluge

April has thundered down upon us in an abundance bordering on drowning:  in rain, in work, in visitors, in emails, in tasks, in blessing, in exhaustion.  We preach pace and sabbath, but in the last few weeks we've been working long days at the hospital and long nights at home.  So many dangling loose ends, threads that have unraveled and not been tied off.  People we've failed to answer, situations we've failed to anticipate, love we've failed to show.  We are worn thin and we are sorry.

A few sips from the deluge to illustrate this month:

Patients, teaching, innovations, audits, deaths, surgeries, procedures (Our normal daily hospital work)

Mama M in the background with baby M, and their incubator-mates . . . still going improbably strong, thanks for prayers!!

Triplets whose mom had been sent here from a private hospital due to lack of space there, at 29 weeks.  The OB team held off labor for a few weeks but they were still born way too small and early.  The boy (the largest) died, but the two sisters are still struggling on.  Keep praying!

One day I just could not understand why my patient's oxygen level was so low, until I moved the bed out from the wall and saw the tangle of the improvised shared oxygen system.  We need better OXYGEN!

Every day brings struggles and joys.  One day last week Scott was on rounds and a mom who was resting on antibiotics after rupturing her membranes almost two months early showed him a green-looking cloth soaked with the fluid.  Preterm babies don't usually pass meconium (stool) so he put on a monitor (something that we can't seem to make standard due to the high volume and poor staffing) and saw a sustained stressed high heart rate.  He was able to push through an emergency caesarean quickly and called me in . . the baby's umbilical cord was not only around the neck but stretched like a sash over his shoulder and across his body and through his legs, a tight mess cutting off his blood supply.  A quick exit and some resuscitation and he did well.  Days like that we think, yes, this is what it's about, saving lives and teaching as we go.  Other days we still despair, as the docs in our county have called for another strike, and the interns are finishing their year with no replacements in sight due to a prolonged lecturer strike.  

Visitors, students, projects, donors (April is a popular month)

Cindy B spearheaded the Friends of Naivasha Hospital organization that raised money for the maternity and NBU--she visits once or twice a year with a whirlwind of innovation and energy.  This time she invited us to an evening safari at a local private reserve.

Former RVA student and friend, who are studying various medical courses in Germany and dreaming of working back in places like this.

Isaiah, a Kule Scholarship student about to graduate in Uganda, took a bus on  his vacation week to come see us in Kenya.  We walked down our hill to see the wildlife . . . 

And he spent his days with us in the hospital.

Dr. Jim O'Neill and family visited Naivasha where he had volunteered and raised funds; a leader in Paediatric Surgery, and still thinking forward at 85 on how to improve care around the world.

The University of Nebraska team donating a Pumani CPAP machine to our NBU (my new Paeds consultant partner is on the front right, Dr. Julie, by our head nurse Epharus, and my former partner who is now medical superintendent of the hospital is in the white shirt receiving the machine)

We spend a fair amount of time with University of Washington rotating residents and students too . . this is Carly who hosted Luke when he was in Seattle doing his away rotation.  Small world.

Teamwork, mentoring, bearing witness (both in the hospital, the community, and Serge)

Most unusual morning in April: Speaking to the East Africa Women's League, some really gritty and gracious women who have lived here since steam boats plied Lake Victoria, and have the stories to tell about it.  They care about Naivasha and gather to support charities.  I was super nervous but they were very kind.

Bethany shall represent the 24 people we supervise (Team Leaders, Area Specialists, and a couple of team members who are lacking Team Leaders), 22 of whom we met with this month in person or by video.  It's our annual review time to reflect on the year and set goals for the next.  Always a delight to see what God has done; but also added quite a bit of work to this month.

The April 2018 Paeds team.  The two interns here (Litole far left and Lokomol center) are amongst the hardest-working least-complaining humans I have ever met. We used to have at least 3 to 5 sharing call; these three months it was only two.  We had some UW med students, and the doc next to me is one of our two medical officers Linda.  I've been working on a core curriculum with a pre- and post-test for the rotation, and one of these women bumped her score by 30 POINTS!  They both learned a lot and were great to work with.

Scott's OB team out for lunch with a visiting University of Washington professor who was here helping set up a quality improvement study of cesarean section delays.  His partner Dr. Chege is front center.  

Serge Family celebrations, kids (both new ones and ours)

Laura Mixon (Serge teen) in the musical "In the Heights" by Lin-Manuel Miranda.  Great dancing and beats, but also a meaningful story about home, families, immigrants, prejudice, injustice, hope.  Really great job by Rosslyn students.  

The Serge crowd who came opening night, with our very own star (and Gaby front left will be in RVA's musical this Spring too).

Photo courtesy of the Kibuye team--they studied inventors and Scott wrote up a story of his dad's work on Pringles, which was fun and sweet.

Baby Jonathan safely born to the Faders at Kijabe, baby Davis' adoption was finally approved in Uganda, and baby Bennie returned with her family the Nolens this month from Home Assignment.  We've added to our Serge family this year: Keza, Davis, Julia, Jonathan, Ivy Joy, Jacob, Bennie, Salem, and if I can also claim him, Clark.  Lots of joy, though we do pray for a couple others who have lost little ones and long for parenthood.

Jack with his Duke Rugby 7's team at a tournament in Nashville (rain there too!)

And Luke got to go on vacation with great friends including Abby, and his RVA pals Thomas and Sierra.  When we are far from our kids, it does our heart wonders to see them with friends.  Julia is one paper and one exam away from finishing college, and Jack is almost done with his Junior year.  Caleb soldiers on (literally) and God willing will complete his first deployment in about a month.  One of the highlights of our month has been a few group-chats with the family.

Scientific Conference and Retreat Preparation (part of life is meetings . . .)

Sergers were strongly represented at the Kenya Paediatric Association meetings this week, doing research and presenting it.  This is part of the Kingdom, making care better for kids.  Above is Jason's project being projected . . 

And here is Caleb from Kijabe presenting one of Ari's several projects.

Scott and I rode down to Mombasa on the train to catch the last day of the conference . . 

And then accompany the Brotherton-Streets to scout out our retreat venue for August. Yes, one of the other MAJOR JOBS of this month has been working on planning a retreat with speakers, logistics, themes, child care, etc. for about 150 people in August.  

So, if you haven't heard from us in a while, perhaps you now know why. Oh, and forgot to mention the edits on the fourth Rwendigo tale due this week and working with the pictures and cover, and lots going on in lives of our Ugandan fostered young-adult kids, and taking a course on HIV, and working on finances and legal issues . . .  Sometimes it feels like our heart is in too many places.  So this quote from a devotion I found particularly encouraging today:

St Bonaventure (1221-1274) called the Trinity a "fountain fullness" of love.  God is unhindered dialogue . . an eternal waterwheel of self-emptying and outpouring love--that knows it can completely self-empty beause it will always be filled back up.  This is the very definition of divine love; all human love merely imitates, approximates, and celebrates this same pattern.  (R Rohr)

The reminder that our resources are NOT limited, that all the pouring out will be refilled, that we are merely channels of the foundational force in the universe, LOVE.  Pray for us to not be irritable and rushed, but to be kind and loving as April turns to May.