A Round for the New Year

"Make new friends, but keep the old: one is silver, and the other gold." Remember that little gem? Our families and friends are such blessings. It is their love that makes room in our hearts for more.

After rounds last Sunday, I climbed the mountain behind the hospital again, this time with two new friends -- Zoe, a medical student from New Zealand, and Leah, a university student from Mercy Home, the orphanage where Zoe volunteers. We scrambled up rocks, enjoyed a sunny view of Lake Victoria, explored the fish farm cooperative, rested at the oldest Anglican church in Maseno, and were accompanied by animated children all along the path. We reached our destination after half an hour, only to learn that our friend Alex had been unexpectedly called away by the bishop to serve in a distant parish.

True to Kenya's Karibuni (welcoming) tradition, however, Alex's elderly parents promptly invited us into their house next door -- with broad smiles, cold sodas and tasty biscuits served by assorted grandchildren. Proclaiming our visit as a gift from God, the patriarch and his family told us tales of his children, asked about our families, and shared our delight in the gala Christmas balloons and streamers hanging from the ceiling of their immaculate home. "God has blessed me today... all of us, from all over His world, are right here in this room!" Baba Alex marveled.

I couldn't help but wonder how our experience might have played out in any other place: three hot, sweaty foreigners arriving at 5 PM on one's doorstep, unbidden and unannounced? What a perfect example of "welcoming the stranger as the Christ." After a lovely visit, amidst hugs all 'round, we exchanged asantes (thanks) and kwaheris (goodbyes) and were urged to return.

Twice now I have been asked by well-intentioned Americans "what demons are driving" me to live and work in East Africa. How can I explain that I don't believe demons are driving any of us -- that, instead, I believe God is calling all of us "wherever we may be" dancing. I'm a very poor rock climber and an even worse dancer, but I am grateful to be around for the new year, to hope and to celebrate with new friends, and to very much cherish the "g/old."

Paul wrote to the Ephesians, "I, therefore, beg you to lead a life worthy of the calling to which you have been called, with all humility and gentleness, with patience, bearing with one another in love, making every effort to maintain the Spirit in that bond of peace." We have seven more new friends visiting Maseno Missions right now, student nurses from Wisconsin, who are also making every effort in the bond of peace.

My heart is overflowing with love from and for you all as we dance, sing and pray together, wherever we may be. Asante, Mungu/ Heri za Mwaka Mpya! (Thanks be to God/ Happy New Year!)

P is for Pneumonia -- and for Prayer

It has been an especially prayerful Christmas at Maseno Hospital.

Festus, 19, died of PCP (pneumocystis carini pneumonia) in Ward I on Christmas Eve in his weeping brother's arms.

Felix, 13, died before he even made it to the hospital on Christmas night, after enjoying his first holiday party ever -- in spite of a cough and high fever.

And Phoebe Leah, 26, is back on Ward II with pneumonia. You remember "Mama Zedekiah." (It is her 3-year-old son's arm that I am holding in the "Hands to Work" photo.) The family that cast Phoebe out because of her HIV status has now quite literally dug her grave. Although Phoebe is still struggling to breathe, she is slowly improving on antibiotics and oxygen. We do not know, however, who is looking after Zedekiah in her absence.

Unthinkable Christmas stories are our patients' everyday realities. Unfortunately, too many people come too late for medical help -- for financial, social and personal reasons. Sometimes it is merely that the cost of transportation is too high. A 20 KSH matatu ride to the hospital is simply too much for someone who is trying to support a family on less than 75 KSH ($1.00) a day.

How can we keep from praying? (For some help and hope, click on and listen to Brother Curtis Almquist, SSJE's "Twelve Days of Christmas" at http://ssje.org/twelvedays/?p=17)

Krismasi Njema

Nan's meatloaf was scrumptuous, and my chocolate chip cookies were a success. We listened to a delightful recording of Harvard University's Christmas Revels last night, Christmas Eve. "Dance, dance wherever you may be... " sings on in my heart. Simba (the dog, not the lion) awakened me with a slurpy kiss this morning, and now we're off to hospital rounds. The banana leaf creche is finally complete, with baby Jesus in his crib. Although our traditional holiday balloons have popped, the "flowers" (tinsel leis) live on in Maseno. So does the spirit of Christmas. Krismasi Njema, love to you all, and God bless us, every one.

Silent Night, Holy Night

And God was a child,
curled up, who slept in her.

And her veins were flooded
with His wisdom,
which is night,
which is starlight,
which is silence.

And her whole being
was embraced in Him
whom she embraced.

And they became
tremendous silence.

-- Thomas Merton

Three Small Miracles

(1) Last night Prince Charming arrived at my door and declared: "Madam, I am here to save you." He was handsome, earnest and about 25 years old. I was somewhat nonplussed before I realized he was the night guard assigned to Rotary House during Emmah's absence. Some things that are lost in translation ("save/protect"/whatever!) can be found in cross-cultural chivalry.

(2) Even more miraculous is the experience of having had 96 -- count them! -- consecutive hours, to date, of electrical power on the hospital grounds.

(3) The most wonderful miracle of all is that my grandson turns 16 today. (How did that happen?) Happy Birthday, Huck!

December Tridium

Every day is a holy day, but my first three back in Maseno seem holier than usual. It's often quieter at the hospital in December because family time takes precedence over inconvenient, even life-threatening, illness in Kenya.

Unless, of course, you're Phoebe Leah, who has no food at all and prefers to stay in the hospital with 3-year-old Zedekiah so her son can eat, thanks to our donors' feeding program. (The hospital census is also down during the three planting seasons of the year. Seeds must go into the ground to feed the living, even when some family members are dying.) With fewer patients, we are even more intimately privy to their life stories...

Christine, 37, was admitted to the hospital because of weight loss, abdominal distention and pain. Physical examination revealed a hard tender mass in her abdomen, and ultrasound showed a coarsened liver. Cirrhosis, malignancy or TB? Regardless, she faces a difficult time ahead as a widow with five children to feed.

Phanice is suffering from cryptococcal meningitis. She's been on Amphotericin B, a toxic medication but our best recourse, for 12 days and is improving, but she still needs almost-daily spinal taps to relieve the painful headaches associated with her illness. Her CD4 count is 25. Soon Phanice will be able to go home to her elderly parents, who are struggling to find a way to pay for even a portion of her hospital expenses.

Zablon, 44, is still combative, but his cryptoccal meningitis is also improving on medication. His creatinine is climbing, however, so we will soon be unable to administer more Ampho B. At that point, we will send him home on high-dose Fluconazole and pray.

Peter, 25, was admitted with multiple compound fractures after a piki-piki (motorcycle) accident. We cannot reduce the fractures here and have referred him to the district hospital in Kisumu, but his family doesn't have the money for transport and wants to take him home instead. If they do that, Peter will never walk again.

Over on "Peds," Joash, 4, is recovering from cerebral malaria. He was in a coma when he arrived but is recovering after two blood transfusions and IV quinine. Precious is 14 months old; she, too, is making a dramatic recovery from malaria. Fortunately, their mamas brought them to the hospital (barely) in time. Sharon, 3, is suffering from cutaneous anthrax. The surface of her hard, swollen jaw is covered in pustules which erode into blackened craters. When Dr. Hardison asked, "Are there any sick cows in the village?" Sharon's mama nodded: "The chief sent a man to give all the cows some medicine." Sharon, too, will recover, but it will take two months of antibiotic medication. We pray her mama will be able to purchase it and remember to administer it. She has three other children at home and is the sole support of her family.

Some of you have already heard the story of 9-year-old Silas. While I was in the U.S., he came to Maseno Mission Hospital's outpatient department complaining of a sore throat. Silas and his family live "inside," away from towns and villages. They drink unfiltered river water, and a leech had attached itself to Silas' tonsils. Harvard Medical School didn't teach "leech-ectomies," but Dr. Hardison dealt proficiently with the situation. Silas went home the same day, with simple instructions for clean water techniques.

Same stuff, different (three) day(s). And so we pray.

Meanwhile, back at Rotary House, I'm settling in and "batching" it for awhile. Emmah is home for the holidays, herself, so I'm trying to live up to my most hilarious high school award: "Betty Crocker Homemaker of Tomorrow." That, dear friends, was 45 years ago, and burnout has definitely occurred. I can foresee lots more PBJ. However, PBJ is more nutritious than the ugali and greens many Kenyan families will share for Christmas dinner. There may be little food and no presents, but, oh, there will be music! ("If you listened...the words would break your heart. Silence, darkness, Jesus, angels. Better, I suppose, to sing than to listen." --John Updike in "The Carol Sing")

Fortunately, Nan and Gerry have invited me to their house to quietly celebrate -- and both are excellent cooks.

Sunrise over Mt. Kenya

Sorry, everyone. My camera was stowed in the overhead bin... But take my word for it: 'twas a glorious sight when I glanced eastward this morning, out the window of Kenya Airways Flight 101, prior to landing in Nairobi. The view almost compensated for the angst I felt listening to Bing Crosby sing his old Christmas chestnuts for hours, over Logan Airport's PA system, prior to leaving Boston.

It's a long way to Tipperary, and it's an even longer way to Kenya via my twelve-hour layover in England. But the two-hour trip from Nairobi to Kisumu via Eldoret was a delight. I sat next to a beautiful six-month-old and her granny, all the while remembering my own six beautiful grandchildren at home. When we deplaned in Kisumu, Nan rushed up to enfold me in her welcoming arms, in spite of her busier-than-ever morning. The harrowing ride to Maseno (thank you, God, and thank you, Kenneth, for safe transport!) was downright nostalgic. After two months of "missionary leave" (not exactly R and R), it seemed to me that very little had changed here. Sunny skies were warming the land and people, tattered laundry was drying on bushes, kids were waving and chanting staccato "How are YEW's?" along the way. (Thank you, Regina, for the photo!)

Fields were fallow after the harvest, but perhaps a little greener following the season of the short rains. Children and livestock were grazing -- sugar cane and grass, respectively -- on the roadside, but they were perhaps a little thinner as a result of Kenya's escalating inflation. (Corn, our staple food, is three times the price it was two years ago.) The hills we climbed in "Private" were perhaps a little more decimated by deforestation, and the air was perhaps a little more polluted by the acrid smoke of burning trash and spilled diesel. But the mosquitoes were as tiny and voracious as ever. (Yes, I'm taking my malaria pills.) When we pulled into the hospital compound, it was equally obvious from the mutual smiles and hugs that "the company of all faithful people" had not changed one bit. "You came back! You said you would, and you did. Karibu and Bwana asifiwe!"

Bing sang, "I'll be home for Christmas, if only in my dreams." Dreams are powerful gifts, thank God... My mother died one year ago tonight, but she, too, lives on in my dreams. And so I send hugs and misses and sweet dreams to you all -- with heartfelt gratitude for your love and prayers as we begin another assignment at Maseno Mission Hospital together.

Annual Letter

Some folks have asked for a copy of the holiday letter we mailed to those of you who kindly made donations during the past mission year. Here you are!

December 1, 2009

Dear Family and Friends,

This is the season of Advent on the church calendar. It is World AIDS Day on the secular calendar. Both are times of quiet remembrance, hope and gratitude. In two weeks’ time, I will return to Maseno Mission Hospital to resume work as your missionary with that same quiet remembrance, hope and gratitude. It has been a joy to be home with you, my children and grandchildren, and to tell the story of Maseno Missions – which fortunately tells itself. The people of Kenya send their greetings and love; I will take yours back!

Archbishop Rowan Williams reminded folks at Lambeth in June that mission is God’s work, not ours, and Archbishop Desmond Tutu declared years ago, “We are all missionaries, or we are nothing.” So we are all doing God’s work in Maseno: we are all walking in our flip-flops together. I hope you have checked my blog occasionally over the past year to learn more about our ongoing efforts at the hospital, HIV/AIDS clinic, orphan programs and theological college. I hope you have seen the photographs of the beautiful, faithful people whom – and with whom – we serve. Above all, I hope you have prayed with us and will continue to do so.

As I reflect on the year gone by, I remember the faces of our patients and our orphaned children. I hope for a healthier future for them and their families. And I am grateful for the opportunity to return to serve in God’s name and in yours. Together, we have truly made a difference; and of course, we will always have more to do. We are excited about the current renovation of the hospital maternity wing, where we will have a functioning incubator; about the imminent visit from Engineers without Borders, who will address our community’s ongoing problems with power and water; and about the possibility of building a roadside outpatient clinic that will reach more people, more effectively, more of the time.

Tax-deductible donations to facilitate these efforts may be made via PayPal on my blog site or by check to St. Andrew’s Episcopal Church, PO Box 1287, Edgartown, MA 02539. (Please note “Kenya Mission” on the memo line.) Thank you for your generosity all year ’round and especially in this season of hope.

Advent blessings,
Dianne