Tuesday, July 28, 2009

More Good-byes

"So long, farewell, auf wiedersehen, kwaheri... And please come back!" we tell our visitors. It is always a gift for us to receive them, and their presence means perhaps even more to the people of Maseno. Visitors bring hope and health (and, yes, grated Parmesan cheese!) to us all, and we hold them in our hearts forever. Lauren, Jordan and Brandon recently left the St. Philip's compound to return to the U.S., and five Children's Hospital, Boston, nurses left Rotary House on Sunday. Asante sana, Elizabeth, Gail, Kathy, Patti and Regina. Oh, how we shall miss you all! God bless you, every one.

Wednesday, July 22, 2009


Do you remember my previous blah-blah-blogs about our neighborhood mbwa? She was the sweet young Mama Dog that Emmah nursed back to health, even as the dog (a/k/a Kate Moss) was nursing her own six puppies -- who all eventually died, apparently from distemper. Mama Mbwa then devotedly followed Emmah and Rotary House residents everywhere, even on hospital rounds. Two weeks ago we had to reluctantly ask her "real" owner to please keep her tied in the daytime because hospital employees were complaining (read threatening to poison her) -- although no one complains about the chickens who freely wander in and out of the wards.

The owner agreed, of course, and Dr. Hardison also began to carry a collar and leash in his medical bag so we could take the dog home if she did get loose and find us. Yesterday we learned that Mbwa had been poisoned, however, in spite of all our precautions. I am horrified as well as saddened. People die here every day, but they die because of disease, not because of malice. Yes, dogs can be rabid; yes, they are used primarily for protection, not for companionship, in Kenya; and, yes, the same owner lost two previous dogs to poisoning. But I have to wonder how much our own misbegotten friendship contributed to Mama Mbwa's death.

Is this another cultural lesson? How many more do I need to learn? Rest in peace, dear friend.

Tuesday, July 21, 2009

The Road to Amagoro

... is paved with faulty material. A recent adventure took us over several kilometers of tarmac which looked more like railroad tracks than road. In addition to the usual potholes, humps of asphalt, running parallel to the roadside ditches, delineated the route. The ruts were a hazardous diversion from the usual matatus, lorries, boda-bodas, goats, cows, chickens and pedestrians that we hurtled past in Missionary/Padre Zach Drennan's refurbished Land Rover. Brandon, a young Diomass visitor, and I were recently Padre Zach's guests -- and the guests of "Bishop Zach" Epusi and his wife, "Mama Catherine," for two days in the Katakwa Diocese.

"A Big Man probably built a Big House with the money he made from skimming the materials list," two of our Kenyan companions chuckled. "And then someone else probably made kitu kidogo (a small 'appreciation') by allowing big lorries on the new road too soon." Barack Obama and The New York Times are right about political corruption here. It's not a new problem, however. That road was built seven years ago. The sad thing is that only the rich get richer. 'Twas ever thus?

Brandon and I both appreciated the generous hospitality of "the two Zachs" and the bishop's household. We also thoroughly enjoyed our visits to Elewana sites (see Zach's blog @ www.elewana.org) and watching "the great tire race" at Amagoro Junior School; walking across the Uganda border to shop in Malaba; and climbing (in my skirt and flip-flops) to the top of the rocks at Kakapel Monument, where cave paintings date to 3000 BCE. 

Along the way, Zach stopped to introduce me to his English class at the Teachers' College, and I suddenly found myself teaching "Health Ed in the Age of AIDS" (a/k/a "safer sex") to bright young Kenyan adults. Took me back a few years... The highlight of our visit, for me, at least, was sharing quiet evenings with the bishop-in-Bermudas, his family and the assorted friends who gathered in the living room to pray.

We returned home to Maseno just in time to say goodbye to University of Wisconsin med students Ali and Holly, and to say hello to five nurses from Children's Hospital in Boston. It is a blessing to be able to share this amazing place with so many wonderful visitors! And it is a blessing that they share their countless gifts with us...

Thursday, July 9, 2009

Mistaken Identity

We had a population explosion yesterday when nine Maseno School students and one faculty member, all with similar symptoms, were admitted to the hospital. Some were "clinically febrile," with low-grade fevers. Most were suffering from headaches, "GBP" and "GBW" (generalized body pain and weakness), mild diarrhea and occasional coughs. Eight have recovered and will be discharged today; the ninth is on the mend.

It's a good thing, since 30 more sick students are currently lining the long portico of our beleaguered Outpatient Department and are sprawling onto the lawn. The hospital matron has phoned the district medical officer to report an "outbreak" of some kind. Fortunately, no one is seriously ill, and we are methodically working our way through diagnoses and symptomatic treatments. It could be anything from malaria to salmonella to shigella to a virus of some sort. "This is winter," said my friend Floice matter-of-factly. "We get sick in cold weather." The temperature recently dipped to 68F at night.

In the midst of it all, two doctors from Kisumu arrived to "investigate 20 (apparently healthy) new foreign visitors" reportedly at Maseno Hospital -- who are not. After some initial confusion, the doctors determined they were supposed to be investigating the "foreigners" down the road at Coptic Hospital -- not here. They went on their way after blandly suggesting, "It could be that your students have malaria." Ayup. But so far no malaria parasites have been seen in our lab samples.

I privately wondered, equally unhelpfully, if perhaps it could be swine flu hysteria (vs. H1N1 itself). Photocopied CDC pamphlets were dropped by helicopter last week and are fluttering about the countryside, listing the symptoms for every anxious child to imagine he has. Or could it be that the students' national exams will start on Monday? I know, I know; I sound like my/a mother... After last week, though, we are grateful that the "outbreak," whatever it may be, is thus far mild.

Saturday, July 4, 2009

Benedictine Balance

Although I have been aspiring to live according to a specific monastic rule for years as a Benedictine oblate, I continue to learn by bumbling along. And I still struggle daily for some semblance of Benedictine balance, or "stability of heart." Hospitality, no problem; humility, okay; lectio/holy reading and reflection, yes; love, by definition; moderation, of necessity; obedience, certainly; peace, without question; service, of course; ora et labora/prayer and work, definitely; silence, um, in the middle of the night when God has a chance to get through; stability... well, maybe.

And maybe not. God must have been shaking her head as my heart was careening its way through these past few days. "This was the week that was" in Maseno, Kenya...

(1) Five days and nights without electricity. Read without emergency hospital equipment, including our new oxygenator. Read without water pumps. Read without security lights. In nearby Luanda, people took matters into their own hands when our police -- "the most corrupt in East Africa," according to a Transparency International report released only yesterday -- neglected to detain an accused thief. The crowd "necklaced" the suspect in the marketplace with a gasoline-filled tire set alight. "Mob justice," it's called. Murder, She Writes. Meanwhile, in Kisii, just southeast of Kisumu, seven "witch lynchings" have been reported recently. The mostly-older people were literally burned at the stake (http://news.bbc.co.uk/2/hi/africa/8119201.stm). Much of the world is obviously in darkness far longer than five days and nights. Perspective, She Prays.

(2) Ten days of escalating tension on the hospital grounds after a series of break-ins. The inquisition and incarceration (better than necklacing and lynching, perhaps, but not by much) of four of our night-time security guards followed, inciting sub-tribal conflict, demonstrations at the gate and mistrust among neighbors. No evidence has been found, and no trial date has been set.
(3) The usual unusual procession of presenting problems in a small mission hospital with good intentions but few resources -- set against, and complicated by, the background above:

Emily, 9, born with multiple problems, is now suffering from fever, Kwashiorkor and as-yet-undiagnosed ulcerations covering her entire body. Unable to see, speak or hear, all she can feel is pain. Emily is receiving antibiotics, corticosteroids and analgesics, all we can offer -- with prayer.

Michael, 13, was admitted in acute pain, another sickle cell crisis that will eventually lead to his death. We have given him a blood transfusion, IV Ceftriaxone and pain killers.

Floridah, 16, came in suffering from severe thyrotoxicosis. She was responding to treatment and about to be discharged when she suddenly collapsed on the ward and died.

Thomas, 19, was given five doses of IV quinine for his "4-plus" malaria, but he is still spiking fevers of unknown origin. He is now on IV Ceftriaxone, our only real antibiotic line of defense.
Tobias, 21, was essentially held hostage at a public hospital for weeks until his family could afford to pay the bill. Brought to our Outpatient Department today, he has extensive pressure ulcers, and his AIDP -- a form of Guillian Barre Syndrome -- is so advanced that there is little chance Johnes will ever walk again.

"Mama Simon" has 25-year-old twins. Both sons suffer from epilepsy, but only Simon lives at home, and Mama is destitute. Her son was admitted with repetitive seizures because there was not enough money to renew his phenobarbital and tegretol. They cost four shillings a day, totaling about $1.50 per month.

Maurice, 32, wasted, feverish and disoriented, was brought in by a neighboring church's outreach team. We await the hospital lab results for his spinal fluid. If it's cryptococcal meningitis or toxoplasmosis, we can treat it.

Samuel, 46, was treated for lobar pneumonia, then discharged from another hospital. Dr. Hardison diagnosed widely-disseminated Kaposi's Sarcoma in his lungs, instead. With so few platelets left, Samuel will not be able to withstand the requisite chemotherapy.

Jacktone, 48, was discharged with analgesics after his biopsy revealed that cancer is causing his liver cirrhosis. There is no more we can provide here -- no morphine pump, no hospice care. And, frankly, three-day funerals cost families a whole lot of money. It is not fair to keep people hospitalized. 

A recent swine flu outbreak in Kisumu was clearly the least of our worries.

The same week, however, five children were sent home after successful treatment for malaria. A pregnant mama delivered healthy twins via C-section. Several students recovered from salmonella infections. A visitor purchased a year's worth of prescriptions for Simon and his brother. The power is on, the water is running, and Emmah is humming. Morning has broken, and it is Independence Day in the U.S. (Expats were invited to a party at the consulate in Nairobi, but that's eight hours away.) Happy Birthday, America, and Happy New Day, Kenya!

We fall down, we get up; we fall down, we get up. Balance? Benedictine or not, I can only continue to pray for it. "We are all such broken people," my beloved sister-in-law once said. Lala salama and rest in peace, dear Jane. And asante/thank you, dear friends and family, for being my community, "the company of all faithful people" that stabilizes every heart. Conversatio morum is a basic Benedictine vow -- the commitment to being a pilgrim, remaining ever open to change and transformation in the Christian life. It is a gift to be walking, praying and, yes, occasionally careening with you on this, our mutual journey. Amini/Amen.