Tuesday, February 24, 2009

Crazy Mzungu

"Ya' gotta' laugh" ("Husaidia kuweza kucheka"), people say. Believe me, I do, especially at myself and especially when I realize how peculiar I must seem to my kind neighbors in Maseno.

Kenyans are very polite, of course, so it is only if I happen to catch the nurses' eye contact during rounds, or glimpse the bowed and chuckling heads on the road, or hear the whispers behind the kids' hands, that I can grin sheepishly in acknowledgment.

Yes, I'm a crazy mzungu/white person/visitor.

Only a crazy mzungu would do leg exercises on tiptoe during rounds. But if I didn't, my calves would cramp unmercifully after working all day on cement and packed-earth floors.

Only a crazy mzungu would jog (very intermittently) down the road at 7 AM. Otherwise, I'd be late for chapel; but bemused Kenyans don't worry a whole lot about "late."

Only a crazy mzungu would read in the sunshine after lunch. "Are you sick, Sister?" "No, warm and happy." "Wow. We only sit in the sun if we have (chills from) malaria."

Only a crazy mzungu would eat ugali with a fork instead of her fingers, but my hosts thoughtfully set out utensils for me.

Only a crazy mzungu would drink "strong tea" (no milk, no sugar) and consider it delicious, although Kenyans make some of the world's best tea. Their "chai" is basically hot sugared milk.

Only a crazy mzungu would prefer drip-grind coffee to instant Nescafe/Africafe. Kenyans also make some of the world's best coffee, but it is considered an export item.

Only a crazy mzungu would feed table scraps to a skinny roaming mama mbwa/dog. Scraps are for people; dogs fend for themselves. (N.B. The Hardisons just added dog food to the weekly shopping list for us. What luxury! Emmah and I and Mbwa are delighted.)

Only a crazy mzungu would still be struggling with the language after four months. My Luo and Luhya neighbors understand one another, as well as me. They speak four languages, including Kiswahili, to my one-and-a-fraction.

I am grateful for their tolerance. I am even more grateful we can laugh together. In every language.

Sunday, February 22, 2009

Smiling through Tears

Spiritual directors invite us to consider the question, "Where is God in this experience?" Some days some of us wonder...

When Christine arrived at the hospital with TEN/Stevens-Johnson Syndrome (a systemic allergic reaction) as a result of taking a prescribed antibiotic to save her life, I wondered. When five children were brought in suffering injuries from a matatu rollover on their way to school, I wondered. When Jesca died at age 23 of pulmonary Kaposi's Sarcoma and cardiomyopathy, I wondered. When two-year-old David developed a high fever and was found to be in sickle cell crisis, I wondered.

When pharmacist Roger's eight-month-old daughter died from malaria in Nairobi, I wondered. When housekeeper Emmah's elderly parents called from up-country to say that they had neither money nor food, I wondered. When Mothers' Union volunteer Magi told me that her adopted orphan was being "chased away" from school for lack of fees, I wondered. When hospital paychecks were issued three weeks late for already-demoralized employees, I wondered.

Where was God in those experiences? I confess I wondered mightily. And then I prayed.

Padre Richard recently gave a sermon at St. Philip's, reminding us that God wants us to smile. I looked around the chapel that day and saw sincere smiles on lean brown faces, regardless of the collective experience of poverty and pain. When he asked us to greet one another, right then and there, the smiles became brighter, even at a time of deprivation and death. (Richard's was the last sermon I heard as my own mother lay dying.) A caring community makes a difference.

Then I remembered the smile from Jesca's mama when I reached out my hand: "Pole/Sorry. I am so very sorry for your loss." And now I remember the smiles of the matatu children after treatment, as we cut off their torn and bloodied (once fluffy organza "mission box") dresses to replace them with brand new t-shirts -- from a smiling Vineyard donor. I remember the smiles on Emmah's face as she hums hymns in the kitchen, regardless. I remember the smiles of kids in America who gave away their Beanie Babies, and I remember the smiles of kids in Kenya who received them.

I no longer wonder. God is here, and God is there. I simply need to re-member. A caring world makes a difference. Padre Richard's closing words posed yet another question, a new song and an unforgettable refrain: "What are we doing to make God smile today (surely through God's own wondering tears)?"

Saturday, February 14, 2009

On the Road

Jouncing through potholes, glimpsing God's glory...

Yesterday we followed a bus labeled "Msamaria Mwema"/"Good Samaritan" part of the way to Eshiamboko. It was an auspicious beginning for our two-hour drive behind the usual clouds of belching diesel smoke and choking red dust. As Kenneth was carefully weaving the van along the "other" side of the road (among cows, chickens, goats, and all manner of people pushing, pulling and otherwise carrying all manner of children and goods), we noticed field upon fallow field in every direction.

People are hungry here, but it is too hot and dry to plant. Sparse, withered cornstalks cower in the shambas/gardens, stooping sentinels against the sky. A testament to both poverty and patience, they, too, await yet another cycle of hope. "The season of the long rains" will begin in April. As we drove through Sabatia and Shinwa, along the bumpy road toward Kakamega, neon-painted signs loomed and disappeared: "Beware of (Sugar) Cane Trailers," "Samwell's Cyber," "Bidii/Strong Saloon," "Klasic Kutz" -- a video store, and "Shinwa Beer Pot." It was momentarily disconcerting to read "Deviation" in front of the Bible Baptist Church before I remembered the British term for "Detour."

The Mothers' Union ladies from the five newest orphan programs in the diocese welcomed us with open arms, sweet tea and even sweeter sandwiches. (Mumias, the centre of Kenya's sugar industry, is not far from the site.) When the meeting began, their music was sweeter still. There is nothing like the joy and power of African women's voices raised in song. Carolyn led the meeting, Nan announced the Lenten tithe of Christian friends in Rome that will provide Easter rice for the entire orphan program, Truphena explained the weekly course curriculum, Gladys and Magi taught a "Water Guard" class, and Nan then described the success of the Liberian women's peace movement.

Cries of "You go, Girls," were enthusiastically interspersed with "Ai-yees," rhythmic clapping and song. When Carolyn introduced me, I shared photographs of St. Andrew's Sunday School students, and of Helen and her friends at Chilmark Chocolates. Just a few months ago, our church school teachers introduced the topic of "mission" to children in Edgartown after telling them the story of the Good Samaritan. Yesterday I was privileged to pass along their hard-earned donations to children in Eshiamboko. Thanks to them and to the staff and patrons of Chilmark Chocolates, two hundred kukus (chickens) will help feed two hundred kids and will begin to provide school fees for them, as well. It is an inspiring story.

Even more inspiring was listening to the collective wisdom and gratitude of the women yesterday. "Asante sana, Mama," the Mothers' Union ladies said to me. "Please tell your children and all of the people who care about us 'Thank you!' You are helping our orphans, but you are also teaching us and our orphans that we must remember to help other children, just as your children do. Our orphans will learn to 'pass it on' and to not be beggars."

You go, Girls, and Bwana Asifiwe! It was a moment of genuine grace for me because I had left a hospital staff meeting earlier this week, shaking my head in disappointment. After an intense two-hour discussion about the importance of our individual and corporate need and responsibility to find ways to help Maseno Hospital survive and thrive, the closing prayer (offered by a, pardon me, male nurse) was, "Mungu/God, we pray that you will bring us another donor." Colonialism and, yes, post-colonialism have left their marks on Kenya.

It is not often that my dismay is so quickly countered by joy. The women and children of Eshiamboko reminded me that we really are made in God's image. We can and do mess things up for ourselves, but there is always a flickering candle, an image of hope.

The efforts of the Mothers' Union are based upon Paul's words in II Corinthians 3: 2-3 (KJV). "You yourselves are our letter (of commendation), written on our hearts, to be known and read by all, and you showed us that you are a letter of Christ, prepared by us, written not with ink but with the Spirit of the living God, not on tablets of stone but on tablets of human hearts." Amen.

Friday, February 13, 2009

Counting Chickens

Yesterday's snail mail included a long, loving letter from a friend: "I'm praying your blog, every death..." and every detail, she wrote. I was deeply moved and very grateful.
Last night Emmah, who is recovering from malaria, and I watched a movie, the generous gift of another dear friend. We saw the 1973 film about St. Francis of Assisi on a DVD on my laptop. (Remember "Brother Sun, Sister Moon" and the refrain "Step by step, stone by stone"?) Again, I was deeply moved and very grateful.

It's been a disconcerting week, so the messages were well-timed. Asante sana, Mungo/Thank you, God, and thank you, friends.

Nan, Carolyn, Truphena, Margaret, Gladys and I will travel for several hours today via tortuous roads to a new orphan program in Eshiamboko Archdeaconry. Among other things, we will formally present photographs of the donors of the "Kids and Kukus" project to the Mothers' Union there. Thanks to St. Andrew's Sunday School and Chilmark Chocolates, the 200 neediest orphans in the five parishes comprising that archdeaconry will begin raising chickens. The chickens will provide eggs for dietary protein, plus a small income so the children can save for their own school fees. (For photos, click on the Picasa connection at left.)

School fees, you ask? Yes, Kenya has ostensibly "free" public primary schools, but new and more prohibitive "fees" are added every term. Peter's situation is a classic example. He is 12, a good student and the son of our neighbor Irene, a hard-working ward attendant and single mama. Peter was turned away from school on Wednesday. He had arrived with the requisite "furniture fee" (for a desk), uniforms and books, but he did not have 4,000 Kenyan shillings, the equivalent of $50, for a "hockey stick fee."

Peter has asthma and doesn't even play hockey, but he is required to purchase a stick. "Mama Peter" spent an exhausting day, missing work, traveling by matatu to borrow money from friends and relatives and to shop for a hockey stick -- only to discover they were out of stock in Kisumu. All that, simply so her son could attend "free" public school. Peter's school finally accepted him on Wednesday night with partial payment of the hockey stick fee and Irene's promise to pay the balance by the end of February. But once again the hospital paychecks (due at the end of each month) have not been distributed.

It puts our U.S. real estate taxes and employment laws into perspective, but that doesn't help Peter. Kenyans (except for the 54 members of Parliament, of course) pay income taxes, but they pay no property taxes. The majority of the population earns less than $1 per day, however, and land titles are in perpetual dispute, so very few people ever own property.

"Step by step, stone by stone," and chicken by chicken... God's time is not often ours, but I am grateful for reminders of His love and yours. So are the orphans in Eshiamboko Archdeaconry.

Friday, February 6, 2009

Out of the Mouths...

It is a gift to be a grandmother. Four-year-old Nell prays "for Granny's work and people," and four-year-old Nico sends emails like the one just received:

Dear Granny,
Thank you for the blog about (sister) Nadia's birthday. I really loved it. I also really loved the pictures. I wish I had a magic wand that made everything that wasn't in Kenya there suddenly.

Nell's prayer, Nico's wish and Nadia's birth make such a difference in my life. Their love -- and yours! -- keep me "passing it on." And whatever else are we here for except to pass God's love on?

Tuesday, February 3, 2009

"Pray the Devil Back to Hell"

The horrific fires this past week in Nairobi and Molo prompted a prayer request today from Carolyn, our Mothers' Union Chair: "I fear that these fires are evidence of Satan in our country."

They are certainly evidence of poverty in Kenya, and Satan has a field day in poverty. The exits of the Nakumatt store in Nairobi were ostensibly chained shut to prevent looting during the blaze. As a result, countless (so far) customers were trapped inside and perished. The tanker fire in Molo was attributed to a confrontation between police who were cordoning off the area and people who were desperate to siphon whatever petrol they could retrieve from the spill. Over 150 people died in that inferno.

We don't often speak about "Satan" in our mainline churches in America, perhaps preferring less graphic references to "evil." Wherever we are and whatever we name it, however, I am convinced Satan/evil is present, and fire seems to be the most recent evidence of it here. Kenya is a land of dramatic contrasts. Both God and Satan are very visible. Every day, I better understand Carolyn's heartfelt request.

Nan shared a friend's review of a new movie that is now playing in U.S. theaters. "Pray the Devil Back to Hell" is the true story of a women's prayer movement in Liberia that led to powerful change in that country. Just as women's peace-making efforts facilitated the resolution of a generations-old conflict in Ireland, so did women's work in Liberia. Nan's "You go, Girls!" has been a rallying cry for the Mothers' Union of the Diocese of Maseno North. Barack Obama's "Yes we can!" has reinforced the Mamas' determination to address hunger, poverty and pain in their own communities.

And so we pray... for Maseno, for Kenya, for Africa and for the world: "Ashindwe!" ("Go back!")

Monday, February 2, 2009


Today is the day that Christians around the world celebrate the presentation of Jesus in the temple in Jerusalem. According to an Anglican website, "The day has pagan roots, with great significance in the rural calendar, because the date lies halfway between the winter solstice and the spring equinox, so it marks the day on which winter is half over... There is a sense in which we thank God we are moving into brighter and better days."

You guessed it: Candlemas is traditionally celebrated with a ceremonial lighting of candles -- "for hope," of course! In that vein, I need to share some of the hope that we have, in spite of our losses. There is much to mourn the world over, not just in Kenya. But there is much to celebrate, as well. Among other things, we celebrate in Maseno:

(1) waking up every day (quite literally);

(2) the return of public school teachers to their classrooms after a contentious strike threatened both the security and education of our kids. Kenya's Parliament has agreed to honor a pledge (over three years' time) it had previously made;

(3) the return of Samuel, a much-respected clinical officer, and the departure of Silus, an equally respected clinical officer -- who leaves to begin medical school in Kenya. When he returns, he will be an even finer asset to Kenya than he is already;

(4) the delivery and implementation of two suction machines, two floor lamps, three xray view boxes and a lifesaving oxygen concentrator for the hospital -- thanks to recent very generous donations from the Rotary Club of Martha's Vineyard and St. Barnabas, Falmouth, Massachusetts. Our patients are even more grateful than we are;

(5) the ongoing success of the 15-growing-to-41 orphan feeding programs in the Diocese of Maseno North, thanks to the Diocese of Massachusetts' Jubilee Committee, St. Christopher's Chatham, All Souls' San Diego, and numerous other supporters around the U.S. These feeding programs provide one hot meal a week and basic education classes for thousands of kids every Saturday. They are beginning to be self-supporting, thanks to a recent micro-lending initiative between the local Mothers' Union and Diomass;

(6) last month's visit by Rosemary Kempsell, President of the International Mothers' Union, who heard about Maseno's orphan programs and came to honor the women here who have been quietly tending the needs of "the least of these" for years, under Dr. Nan Hardison's tutelage;

(7) the delivery of 200 kukus (chickens) to 200 kids in the diocese, orphans who can use the protein as well as their egg money to buy the requisite uniforms and books in order to attend "free" primary school in Kenya. Employees and patrons of Chilmark Chocolates on Martha's Vineyard and the Sunday School kids at St. Andrew's, Edgartown, made the "Kids and Kukus" project possible. The Mothers' Union and the parish priests have helped us identify the most needy orphans;

(8) waking up every day (did I mention that?);

(9) a pilot project to empower women, feed children and provide safe (vs. counterfeit) medications at reasonable prices in two new community pharmacies. The women of the Mothers' Union are structuring these ventures, as well, which are supported by start-up funds from Boston and facilitated by Dr. Gerry Hardison and Maseno Hospital's pharmacy;

(10) a fledgling effort to help the 35 students at St. Philip's Theological College, continue their studies under Nan's direction and take their exams. Most of these students have young families that have been hard hit by the triple-digit inflation in Kenya over the past year;

(11) the upcoming visit of SSJE Brothers, who will lead a retreat for those same theological students;

(12) a new long-term program to provide a lightweight washable blanket for every orphan in the diocese (yes, thousands in all) at a cost of $7 each. These kids often have no bed, sleep on a dung floor, and are just plain cold at night. Even in Kenya, the temperature gets down to 60F. That's nippy, especially during "the season of the long rains";

(13) the efforts of the fledgling Rotary Club of Kisumu, which has taken on a community-wide "Jiggers Project" and yesterday completed a new addition with a cement floor for a family living in a jiggers-infested house;

(14) the re-establishment (in process) of a community well; it will better serve the hospital and environs than the current erratic municipal water supply;

(15) and, yes, waking up every day!

For all of these things and many, many more, we thank you, dear God. We thank you, too, dear friends -- for "lighting one candle for hope" with us all. Asante sana!

Sunday, February 1, 2009

Multiple Losses

Hellen, a very reliable Ward I nurse, was absent yesterday. Two of her sisters were among the victims trapped unmercifully inside the downtown Nairobi Nakumatt (Kenya's equivalent of Walmart) when it caught fire Friday. At least 40 people died because the doors were locked when the fire broke out "to prevent looting."

We learned Thursday that Rabson, the young boda-boda driver whom we had discharged on TB medication January 20th, died at home ten days later. His family reported that he had refused to eat... but no one brought him back to the hospital for NG tube feeding. Although we had admitted him at no charge, they said they were afraid of incurring any expense.

A sister of Japhreth, our lab technician, was clearly suffering from aplastic anemia a month ago. We referred her to the Provincial Hospital in Kisumu, which was ostensibly better equipped to deal with her needs. However, she and her newborn died in childbirth a few days ago.

Dorcas, a beautiful 10-year-old diagnosed with Guillian-Barre, died at home in Esiola last week. Her caregivers had insisted that she be discharged, against medical advice. They asked the orphan program for help with the burial expenses, or we might not have otherwise known.

Paul, a young man riddled with malignant tumors, and Erasmus, an elderly man with the same, are being discharged today with pain medication. We can do no more for them here.

Zablon, 10, was admitted with staph abscesses over almost every joint in his body. He was also limping. Upon xray, Zablon was diagnosed as having probable osteomyelitis. His left femoral head (hip) has essentially disintegrated, and holes are visible in multiple bones. We can prescribe cloxacillin for the rest of his life, but Dr. Hardison says no surgeon in Kenya would operate.

We are still giving almost-three-year-old Zedekiah lots of rice and beans and eggs and TLC, as well as ARV's, anti-TB meds and now steroids. However, he still weighs 7 kgs (about 15 pounds), and there will be no food for him at home. His mama is too sick to work, his father has abandoned them, and Zedekiah cannot survive on USAID supplements alone. He was hospitalized in November, then again in January. Will we see him again?

Dr. Hardison drained six liters of bloody abdominal fluid from Christabel, 48, yesterday. She is much more comfortable now, but she will be discharged home with very little time left. She has been diagnosed with Budd-Chiari syndrome, secondary to a hepatoma (liver cancer).

Rosemary, also 48, lies in a semi-coma on Ward II. She is apparently suffering from an HIV-related encephalopathy, with left hemiparesis and intermittent seizures. We can control the latter, but we cannot make her well.

"Some days are just too sad," as Linet says. I'm glad it is Sunday; I can go to St. Philip's to pray in the company of kindred spirits. May God grant us the serenity...