Asante Sana (Thank You)

This is St. Andrew's Day. I thought gratefully of Susan leading Morning Prayer in English in Edgartown while I was worshipping in Swahili in Maseno. And I delighted in the little "Forward Day by Day" message which focused on the immediacy of Andrew's reply to Jesus' invitation. I'm not Andrew, and I'm certainly no saint, but the opportunity to come to Maseno in November -- and, for that matter, to go to El Salvador in June -- just plunked themselves into my lap.

It took less than seconds, each time, for me to say "Yes!" To my amazement, every one of the "How's" fell promptly into place. So while many of you may have wondered at my judgment, or lack thereof, I am grateful to all of you in my family, at St. Andrew's and throughout the world. You have supported those "Yeses" in so many ways for so many years, including your tolerance of my blogging! Asante sana.

Two days ago, another Andrew, a 23-year-old from Nairobi -- which is seven hours away by matatu -- was admitted to the hospital with a recent history of inexplicable vomiting. Dr. Hardison's endoscopy revealed a pyloric mass, a tumor in his stomach. Frustration began anew, since the scrapings must be examined at a distant, more sophisticated lab before appropriate treatment (surgery vs. chemotherapy) can be determined. Either will need to be provided at another site, since we have no qualified surgeon and no chemo department here. It may be two weeks before we receive the lab results, so we can only keep Andrew as comfortable and as hydrated as possible for now. Delays like this make the Vineyard's MVH/MGH connections appear nothing short of miraculous.

Emmah's six-year-old niece ("Diana, your namesake," she smiled) was admitted yesterday with a very high fever and convulsions. We hope that her elevated temperature and white count might be related to a small abscess on her hip, not to malaria. A wound culture is being done at our own hospital lab. Meanwhile, Diana's temperature is subsiding, and she has had a good night's rest.

Evelyn died last night, two hours after she was admitted with acute cryptococcus meningitis. She had been followed by a distant CCC and referred to us too late, in a coma, with a fixed and dilated left pupil and apparent left hemi-paresis. Although she was gravely ill upon arrival, it felt like a truly unnecessary loss.

My amateur PT efforts continue with Jessica and Ruth, each of whom is struggling to regain the ability to walk. I glimpsed the smallest of smiles today on Jessica's face when I used her stuffed rabbit, "Maureen," as incentive to get Jessica to raise her legs a little higher. Ruth seems much less depressed and much more motivated than her counterpart; she actually took three small steps with the only walker on the ward this morning. "Three small steps for womankind," I told Ruth; but I could only say it with a smile -- not in Swahili, nor in her native Luhya.

A 17-year-old girl was admitted this afternoon in a coma. She is recovering after attempting suicide by ingesting rat poison/ warfarin, following an altercation with her sister. Another new admission was a hypoglycemic male, 49, with a known history of alcohol abuse. His condition is complicated, however, by a severe aortic insufficiency; this is the first time I have palpated classic "gunshot" femoral pulses. He has both systolic and diastolic murmurs, and his EKG shows marked deviations at V6, V5 and V4. He has no fever and is negative for VD and HIV. Among other things, we are concerned about renal shutdown. I wish we could just pick up a phone and call Steve Miller.

People come to Maseno Mission Hospital from all over Western Province, Nyanza and beyond. When admitted before the end stages of life (and sometimes even then), they get well here. The word has spread. Please hold Andrew, Diana, Evelyn, Jessica, Ruth, their families and the hospital itself in your prayers. Please also hold Nico, my three-year old grandson who is again struggling with asthma, and his family in your hearts. "Keep watch, dear Lord, with those who work or watch or weep this night, and give thine angels charge over those who sleep... Amen."

The university's cybercafe is closed on weekends, so I'll try to write again Monday. It is the only way my feeble brain will ever begin to remember and share the countless blessings of this time and place. Asante sana, dearly beloved friends.