Going to the Dogs

We all wonder every day, every year if the hospital and the theological college -- and our patients and students -- will survive. We all wonder about that especially during the month the Hardisons return to the U.S. for their annual leave. Somehow, some way, God intervenes and things do work out. "Maseno Missions" is not going to the dogs. I am. And I am delighted.

Some of you know that Simba, the Hardisons' "lion" of a dog (who is actually a big pussycat), has been their constant companion for eight years. He has warmly greeted many a student and visitor -- just as he has unwittingly intimidated many a toto (child) and askari (guard). Some of you also know that Little Brown, a neighbor's pup, adopted the Hardisons a few years ago when word leaked out in Maseno that the wazungu of St. Philip's were as generous with their "Nice Biscuits" as with their overall Christian hospitality.

No one will ever be able to substitute for Nan and Gerry anywhere, of course. But in their absence, I can at least feed and brush and "love up" Simba and Little Brown. So, in a few days, I will move 3 kilometers to St. Philip's to dog-sit. Since I'd been hoping to go on retreat, as a sort of transition between Kenya and my own home leave in the U.S., it will be a particular pleasure. God ("dog spelled backward," as my kids once reminded me) does work in mysterious ways.

Please pray for the Hardisons' safe travel, quiet respite and merciful return. May we all remember the blessings of Holy Week, dear friends, this Palm Sunday and every day of the year.

Questions, Anyone?

My current mission year will be interrupted by a requisite summer-job "sabbatical" at home. While I'm saddened by the prospect of leaving our Kenyan friends at the end of April, working on the Vineyard for a few months will provide an opportunity for me to earn enough money to return in the fall.

Meanwhile, it's a joy to be able to make the most of this "final" month at Maseno Mission Hospital. I have bought some story books for Pediatrics and have begun reading to our kids -- alas, in English, not Kiswahili -- whenever we have time. It's lovely to be able to provide some diversion (besides kuku-catching), as well as some professional care.

Thanks to the efforts of visitors Drs. Christiana and Stephan (her brother) Russ, we've also put up whiteboards on the hospital wards, in an effort to improve communication among our nurses and to better coordinate patient care. After a somewhat belabored "trial run," most of our nurses are now using them. Hurrah!

While I am still here, do any of you -- dear friends and "children of all ages" -- have any questions? Please feel free to ask! I'll be happy to accumulate questions and answer, as best I can, so that all can "hear." (If you prefer to ask via email, rather than via blog, send your questions to dianne.smith.rn@gmail.com)

There is still so much to learn and share! I continue to listen with the ear of my heart and to thank you all for your love and support.

Tetanus

Another day, another disease we rarely see in the USA...

I love learning and doing all that I am in Kenya, but the price sometimes seems too high. For every illness there is a patient in pain, and we cannot always help.

Everlyne is one of them. Seventy years old and of strong Luhya stock, she has worked every day since childhood in the shamba (garden) to grow food to feed her family: first her siblings; then her children, grandchildren and now great-grandchildren.

Two weeks ago, Everlyne cut her shin with a hoe and ignored the wound. Nine days later, her worried family brought their beloved matriarch to Maseno Mission Hospital. Her neck was rigid, her body was stiffening, and she was experiencing repetitive spasms.

We administered tetanus toxoid (too late) and immune globulin (probably also too late). She is getting IV fluids and 10 mg. of diazepam (Valium) IV every four hours. But we are essentially watching her die, helpless here to do anything more.

It is heartbreaking to witness Everlyne's suffering and her family's grief. Please pray for us all.

Kuku

Yes, I am. That's what all the kids on our Pediatrics ward think, too. Hospital rounds are always fascinating and often intense, but today's were more diverse than usual. Dr. Hardison appointed me the official "kuku-catcher."

"Kuku" is the Kiswahili word for "chicken." The two kukus who used to wander through our hospital wards actually took up residence there a few weeks ago and began to roost. Be assured that I like chickens, some of my best friends are chickens, and my clever grandchildren even raise chickens. But not in a hospital. Chickens are not the tidiest of creatures, and they leave... um, you know.

We scouted unsuccessfully for the kukus' owners. We shooed the kukus out the doors, only to find them coming back in the windows. We sent word to the community that we might be a mission hospital, but that we could not provide room & board for their fowl. It was all for naught, however. Last week, Dr. Hardison, concerned about the potential health risks, sent a specimen for culture to our lab. "What is it?" the lab tech asked. "Read the label," the courier responded. "Chicken shit," the neat print said. (Pole sana/so sorry!)

Today was the day set aside for the great kuku caper. It is important to understand that, because chickens are valuable property in a country with very little food, absconding with chickens is something akin to cattle rustling. People go to jail in Kenya for far less, and jail is not a pretty place to be, especially here. As a result, no willing kuku-catchers were to be found on our hospital staff, and I... Well, my job description as a missionary is to "help Dr. Hardison at Maseno Mission Hospital."

So I dutifully found a cardboard carton -- with an unfortunately flimsy top and bottom that I carefully reinforced with used "strapping" (adhesive tape) appropriated from the ward. At the appointed hour, I cornered the kukus, who are particularly fond of the tidbits of food "accidentally" dropped by our Peds patients. And the great chicken chase ensued. The children were intrigued, although I'm sure their mamas were skeptical, to witness a crazy mzungu sneaking up on those (pardon me) poor dumb clucks.

To our mutual amazement, I efficiently scooped up the first hen and deposited her into the waiting box. It was great entertainment and everyone clapped, but my beginners' luck was short-lived. It took 15 minutes, several ruffled (and lost) feathers, some desperate squawking (not mine), and ultimately a hospital blanket to capture the second culprit. Definitely the worse for wear, two iffily-crated chickens and I then carefully made our way to "Bruiser," the Hardison's old Land Rover, in the Maseno Hospital parking lot.

Dr. Hardison drove the finally-subdued creatures three kilometers to the hen house at St. Philip's Theological College ... "A nice Christian environment," he explained. I hope the judge will agree.

Jenipher

She's my age, a grandmother, and the sole caregiver of three young children whose parents died of AIDS-related complications.

Jenipher was admitted four days ago with second degree burns on her face, head, neck and left shoulder. She could neither speak nor open her eyes because of extensive edema, and her pain was great.

"A known epileptic," Jenipher had been diagnosed 15 years prior but was not on anti-seizure medication because the cost was prohibitive. She apparently had a seizure and fell into the cooking fire on Monday about noon.

Her grandchildren ran for a neighbor who brought her to the hospital five hours later, after collecting 115 shillings ($1.50) from the community for piki-piki (motorcycle) transport.

Jenipher arrived in shock, with a BP of 70/50, T 34.1C, her pulse faint. We administered Pethedine (a Demerol equivalent) and IV fluids, cleaned and applied Dermazene to her wounds. That was all we could do except pray.

Her vital signs are improving. The swelling is diminishing, and Jenipher's oozing eyes are opening. It is too early to determine any damage to her sight, but we cleaned her eyes and applied TEO (tetracyclene eye ointment) this morning.

A cast iron "cage" protects her head and shoulders from the weight of bed linens, but her pain continues to be intense. Her burns will be debrided under general anaesthesia today. Please pray with us -- for Jenipher and her grandchildren.

Sticky Situation

A funny (OK, a funny-and-sad) thing happened on the way to Kisumu.

Yesterday, a lorry overturned on the stretch of highway between Maseno Hospital and St. Philip's. A large crowd had gathered by the time we passed. We worried that it might portend another Kenyan horror story you'd read about in the newspaper: "Explosion kills hundreds as residents siphon spilled petrol."

Instead, we learned that a molasses truck had spilled its contents. Fortunately, no one was hurt. Throngs of people rushed to the site with jerry cans and rags to soak up the molasses from the road, wring out the rags into cans, and lug their "found treasure" (well-seasoned with grit) home to use in cooking.

Today, walking to weekly chapel, I chatted with a neighbor who was carrying a baby on her back and bananas on her head. Engrossed in the conversation, we didn't notice the large dark spot on the highway until we stuck to it. After a lot of laughter and a less-than-graceful extrication, we went our separate ways. When the choir began to sing at St. Philip's, though, I got the giggles again: "There is a story sweet to hear..."

But there is nothing funny about families that are hungry enough to scrape molasses off the road.

Sister? Kuja/Come

Judith, 22, was admitted to the hospital yesterday afternoon, HIV positive, feverish, emaciated and mute. She had been beaten by her disappointed family after she returned home, newly-diagnosed with AIDS. Judith had dropped out of Form 2 (10th grade) to live with her boyfriend. He broke up with her when she became sick.

Our friends at Christ's Hope, an area outreach agency, brought her to Maseno Mission Hospital. They were en route with another patient in their van when they saw Judith being pushed up our long red road in a wheelbarrow by a young girl. We admitted Judith, started IV fluids and began basic diagnostic tests and treatment.

This morning we learned that, before beating her, Judith's grandmother and older sister had shamed her for not attending a charismatic healing service to "cure" her AIDS. After she became hysterical, they took her to a mental hospital. There she was given a double dose of Largactil (Thorazine) and sent home -- whereupon her younger sister intervened.

Judith became more alert, but then agitated, on our ward as the evening progressed. She had a difficult night, pacing the floor and trying to leave. The staff nurses repeatedly coaxed her back to bed. But she was resting quietly by morning rounds, and her fever (possibly a reaction to the anti-psychotic medication) was down.

This afternoon, as I was working nearby, Judith softly called me to her bedside: "Sister? Kuja/Come." I reached out to hold her hand and then leaned close to hear her. She looked into my eyes and said in a slow, clear voice, "I love you with the love of God."

I couldn't hide my tears. I said, "I love you, too, Judith. Your sister loves you. And God loves you. With all this love, and with the doctors' help, you are going to get better. I promise. Do you know where you are right now?"

"I'm in Maseno Hospital," she replied coherently.

"Yes. And you are safe here. Can I get you a sip of maji/water?"

"Just hold my hand," Judith responded.

We gently held hands until she fell asleep.

Please pray for Judith, her family and families everywhere.

Pirates!

Not Somali pirates. Kisumu pirates. We live way too far from the coast to encounter trouble on the high seas. But a recent trip to the Nakumatt yielded big treasure for our visitors this week: pirated videos -- 5 for 100 KSH/$1.25. Thank you, Anna!

Last night at Rotary House, five of us huddled on hard chairs around a laptop for two hours after dinner, eating popcorn made the old-fashioned way (no microwave here), drinking 30-cent sodas, and watching "Night at the Museum."

Aaaaaargh! Who says missionaries don't have fun?

P.S. The photo above is of the cutest (and fiercest) pirate I've ever met: my grandnephew Sam!

The Good Side

That's what Kenneth responds when new visitors asks him at the airport, "Which side of the road do you drive on in Kenya?" Fellow-travelers nod knowingly as they swerve around the ruts. (Note: If there were a decent road, we'd drive on the left side here.)

We negotiate some of our days at Maseno Missions the way Kenneth negotiates the roads. Some days we weave all over the place in an effort to simply stay on "the good side." And some days it can take real effort to even see the good side, much less stay focused on the road ahead.

Wednesday mornings help me see and help me focus. I love listening to St. Philip's choir and Padre Richard's sermons, and I am grateful to receive the Eucharist. This morning's Gospel reading was II Corinthians 4: 7-12, in which St. Paul concludes, "So death is at work in us, but life in you."

After today's 7:30 AM service, the choir called me aside to say "Asante sana." Each member proceeded to describe, in turn, the excitement of singing in a recording studio for the first time and the joy of knowing that over 150 people have already purchased their songs -- an accomplishment which has reduced their theological college tuition accordingly.

"We want to make a better CD now, but you taught us to believe in ourselves," they said. I told them I would share their gratitude with all of you who worked so hard to engineer the sound track (Helen), create the graphics (Marie) and promote their production (Cape & Islands, Honolulu & DioMass' Jubilee) -- and with all of you who bought their CD's, as well!

Choir members presented me with a beautiful cotton kanga (3-meter fabric), on which is printed the phrase, "What God has opened, no one else can close." When I said that God had surely opened their mouths to preach and sing, they kindly responded, "And God opened your heart to hear us."

I am reminded of St. Benedict's words, "Listen with the ear of your heart." May we all open our hearts, sing together and stay focused on "the good side" of the road, wherever it may lead. Yes, death is at work. But life is, also.

Anthrax

Cute little guy, isn't he?

Caroline, 10, presented with an edematous face, her eyes swollen closed. She had no fever, but she had a raised circular lesion in the center of her forehead. It was necrotic at the perimeter, pus-filled in the center, and measured about 5 centimeters. The child reported in precise schoolgirl English, "I was beaten (bitten) by something at night one week ago."

We've seen several cases of anthrax here, but they've been isolated incidences. Cutaneous anthrax is caused by spores in the soil from infected livestock -- usually cows, goats or sheep. The spores, often carried on animal hair, infect a person's skin, usually through a small cut or pimple -- in this case, probably an insect bite. The wound fulminates into an unsightly, but painless, raised crater which may take months to heal.

In spite of its grotesque appearance, cutaneous anthrax (with a 20% mortality rate) is far less deadly than the airborne variety, and it is readily treated with long-term oral antibiotics. We cleaned Caroline's wound, applied a clean gauze dressing, prescribed Ciprofloxacin for 60 days and sent her home. We also asked Mama Caroline to alert her neighbors about the possibility of sick livestock making other people ill in the community.

I'm in the habit of petting the hospital's friendly cows and goats, en route to daily ward rounds. The gentle creatures provide both milk and meat for our patients. I'm also in the habit of using hand sanitizer now. Unfortunately, 99.9% of Kenyans don't have any.

Missionary Midnight (9 PM)

I'm up way too late. Lives and loves and deaths and hates have passed in front of me today. All I can think about is relationship.

I can only imagine the feelings of the 9-year-old who was raped by a relative and must undergo a month of HIV prophylaxis after surgical repair of her vagina. I can only imagine the worry of a mama whose 4-year-old is still in a malarial coma. And I can only imagine the relief of a wife who will take her 92-year-old husband, the sub-chief of their village, home tomorrow, after a successful prostatectomy.

The reading for March 2nd in my Forward Day by Day is Mark 3: 19b-35: "A crowd was sitting around him, and they said to him, 'Your mother and your brothers and your sisters are outside, asking for you.' And he replied, 'Who are my mother and my brothers?' And looking at those who sat around him, he said, 'Here are my mother and my brothers! Whoever does the will of God is my brother and sister and mother.'"

Whoever is reading this late-night message is my own brother and sister and mother. Thank you for knowing, caring, loving and praying for us all in Maseno -- as we do for you this Lenten night.