Q & A, P & P

(P & P = Pups & Prayers)

Mbwa is looking better these days, but one of her six puppies has died. Another was brought to our house today. Shivering and emaciated, he is half the size of his siblings. He doesn't nuzzle to nurse, and his mama ignores him, so one of our young visitors fed and bathed him. The pup weakly wagged his tail in gratitude, then collapsed in exhaustion. Fleas still swarm on his soft pink underbelly, flaunting their survival after a misbegotten squirt of "Doom," Kenya's version of "Raid."

Are we prolonging the inevitable? Perhaps. But there is a chance he will survive. Are we fostering dependency? Certainly. But Gerry encouraged us to feed Mama Mbwa, and he buys her food. Is there any parallel between nurturing the malnourished porch puppy with wobbly legs and treating our malnourished hospital babies with vacant eyes? Undoubtedly. Because starvation cannot, will not, must not be ignored.

Mama Mbwa's other pups will soon be sold (as watchdogs, not as pets), bringing much-needed income to their owner's family. The sick toddlers in our hospital who survive could someday farm this land, providing food for others and for themselves. Were it not for "accidents of birth," their fragile lives might have developed very differently. Are we helping or are we interfering? Come and see. Is there a better way? Come and help. Who is to judge? Let us pray.

"The People God Forgot"

A nurse confides her despair: "We are the people God forgot."

The rainy season is late this year, and everyone is worried. The hailstorm we got last week was apparently not the harbinger we'd hoped for, and people are frightened. Many are already without food (expensive after last year's inflation) and without means to buy seeds, supplies and fertilizer (ditto). Being without rain now means that even those who can plant will bring in a late harvest.

Some of our patients who can't afford their hospital bills are leaving too soon, against medical advice, in order to be honorable about payment. Several hospital staff members have malaria, so perhaps that means that the air is more humid (and more mosquito-laden) and that the rains will soon begin? Times are indeed troubling. The Kenyan embassy recently issued a cholera alert, specifically including Western and Nyanza Provinces.

I could only muster a gentle hug and a firm response to the nurse on Ward II: "God doesn't forget people. We will make it through this together." The U.N. has apparently doubled the food aid to Kenya, but God knows when -- and how much of -- that will filter down to the folks who really need it. Meanwhile, we keep on keeping on, grateful for each day and for your prayers. Asante.

Mothering Sunday

The fourth Sunday in Lent is celebrated in many churches throughout Europe (and its former colonies, including Kenya) as Mothering Sunday -- now sometimes called "Mother's Day," per the American tradition. Children present fistfuls of wildflowers to their mothers as gifts. However, Mothering Sunday has a long church history, vs. our more contemporary secular celebration in the U.S. Hundreds of years ago, people made pilgrimages to the largest medieval cathedrals, or "mother churches," in their own respective regions.

The Gospel lesson in the Anglican Church today is the story of the feeding of the five thousand. As a result, in many places Mothering Sunday also represents a brief lifting of the Lenten fast. In ancient times, household servants were permitted to have this one day off a year to go home. They would often make "seminal cakes," or marzipan fruitcakes, as gifts to take to their mothers. Eleven small eggs, representing the 11 apostles (no Judas Iscariot!), would be baked into the center of each cake. The custom of the seminal cake has been transferred to Easter Sunday in many countries in modern times. In rural Kenya, however, few people would have the means to buy the ingredients for a seminal cake at any time.

Whatever the country, whatever the tradition... Today, especially, I honor the memory of my own mother and grandmothers, as well as the lives of my daughters and daughter-in-law -- wonderful mothers, all! I also honor the Mothers' Union "Mamas" who are so generously caring for the orphans here in the Diocese of Maseno North. Happy Mothering Sunday, Everyone!

The Sky is Falling

A freak hailstorm startled us all this 75-degree afternoon and sent everyone running for cover.We had been gratefully watching the thunderclouds form, since everyone desperately needs water, when "the season of the long rains" started off with a bang...

And the banging didn't stop. We have described the sound of rain on corrugated iron sheets as "laughter on the roof." Well, the sound of golfball-sized hailstones (yes, they do exist) more closely resembles "cannonfire inside the tank." No one had ever heard or seen anything like it, including me. Mbwa, the emaciated mama dog who recently adopted Emmah, raced inside the house and hid under my bed for an hour.

We half-expected the hospital to be filled with head-injured patients when we returned for afternoon rounds. Instead, some badly-shaken staff members were still cowering behind closed doors. There are bullet-type holes in the newer plastic "skylight" sections of the walkway roofing in the Outpatient Department. We continue to marvel tonight at the power of the storm -- and to give thanks for the rains that finally followed.

The Wheels on the Chair

go 'round and 'round...

Actually, the rims (no tires, no brakes here) of the wheels on my borrowed wheelchair did go 'round and 'round, but I am still grateful to be out of it. The friends who have been pushing me through the wards and over the rubble are undoubtedly even more grateful. Thank you all for your love and prayers. My knee is finally on the mend: I graduated from the chair to a cane to just-an-ACE-bandage over the weekend.

In the meantime, life and death in Maseno go 'round and 'round, too. We had thought perhaps it might be a light day, but just as we were finishing Sunday morning rounds, an 18-year-old boda-boda driver was brought to our outpatient department by the car that had hit him. He was unresponsive. Our visiting young medical professionals valiantly suctioned and intubated him. An hour later, we had to tell his mama (with the help of a kindly ward attendant who translated) that we had done all we could... The strains of gospel music being broadcast via loudspeaker from a nearby mountain chapel brought little comfort to anyone.

We also lost six-month-old Agnes this week. She came in with a history of 106-F degree fever for several days. She had malaria and was simply too dehydrated for too long. Susan, our newest Ward II admission, will begin TB therapy and PCP pneumonia this evening. Her sputum was positive for TB, her temperature is 105 F -- and she is six weeks pregnant. Susan is so sick, but so willing to be better, that we hope she may yet rally.

Zedekiah and his mama returned to Ward IV today. Remember the (now)- three-year-old who looks six months old? This time his mother, Phoebe Leah, is sick with giardiasis, and both desperately need nourishment. Many other admissions, procedures, deaths and births (only one Barack, though) have taken place this past week at Maseno Mission Hospital. Thank you for sharing and praying through them with us. 'Twas ever thus in Thornton Wilder's, Ed Coogan's and "My Town."

Construction continues on Ft. Jesus, the employee housing units next door that needed extensive renovation, and on the hospital's outpatient and administration buildings, as well. CCC services will soon be incorporated into our outpatient department to "better serve" our population. The move represents a new direction in the approach to treatment of HIV/AIDS. NGO's hope that reclassifying HIV as "just another chronic disease" might help to reduce the stigma. The wheels of the world go 'round and 'round.

Uchungu

No, that's not Kiswahili for "sneeze." The word means "pain," and we've had a tad too much of it this week, thank you very much. In addition to our patients' always-serious problems...

On Thursday evening, two prominent human rights activists were gunned down at rush hour in a cold-blooded shooting in Nairobi. BBC News Africa reported the incident as "Murders Most Foul." Hours later, one student was killed by police in a related incident. An uneasy peace currently reigns on the streets of Kenya's capital, but the political repercussions remain uncertain. We are far from Nairobi here in Maseno, but pain and poverty connect us all. Violence and injustice weigh heavily on hearts throughout the country and throughout our world.

On the home front, we have renamed Rotary House "Ward V" and incorporated it as an extension of the hospital. Nurse Emmah is tending the ills of both of her guests. Meera, a bright young medical resident from the University of Vermont, arrived Thursday for a month; she is suffering from "Kibaki's Revenge" today. Meanwhile, I fell in love last Sunday (see previous blog) and began suffering those predictable pangs midweek.

Remember that walk SRAIGHT UP the rocks for a well-baby visit? Well, we had to come straight down them, too. I've been hobbling ever onward, but my left knee has been protesting vehemently. Now fully equipped with Gerry's ACE bandage, Nan's adjustable cane, and Rocco Monto's prednisone pack, I trust "all shall be well." (If it's not, I'll get an xray as soon as the hospital pays its electric bill and Kenya Power switches us back on. We have no MRI, no CT and no PT except my own progressive little rocks-in-plastic-bags routine.)

Uchungu. God bless us, every one.

I'm in Love

Meet one-month-old Michelle (yes, as in Obama) Celine Eva... as I did today, on a home visit, after a long walk through the forest and STRAIGHT UP the rocks behind Maseno Hospital. She's too young to be frightened by a mzungu, and I'm too old to be bothered by a wet nappie. Michelle's father Alex is a student at Maseno Theological College; her mother Rhoda is a nurse. To learn more about them all, see my 12/19/07 blog entry "Son of Kenya," and see my picasaweb album "Alex & Family."

Can you tell I miss my grandchildren?