Barikiwa!

That's not Kiswahili for "Turkeys!" Barikiwa means "Blessings!/ Thanksgivings!" (to you all).

One of my brilliant nieces maintains three amazing blogs, as well as a beautiful "gratitude list." I seriously considered doing the latter but quickly gave up. I'm a whole lot older than she is, so my list was too long before I could even begin to write.

I can only tell you that I am thankful every day for every one of you who cares about me and the people I love -- including the people of Maseno. Be assured that we cherish you, too, and that we hope you'll have a blessed Thanksgiving Day/Week/Year!

When I was very young, I was grateful, at this season of the year, for the turkey stickers posted on the pages of my homework. Nowadays I am grateful, at every season of the year, for the prayers posted on the tablet of my heart. Asante sana.

Three Babies, Three Days

No, not joyous births. Needless deaths. Kelvin had cerebral malaria, Juliet had enteric fever/gastroenteritis, and Mika arrived in end-stage renal failure. All three babies had been previously misdiagnosed and given inappropriate medications at other, more accessible area clinics. When they were finally brought to our outpatient department, they were promptly admitted to the hospital. But it was too late. Kelvin and Juliet were so dehydrated and anemic when they arrived that we could not help them -- not even with "cutdowns" to get IV fluids (and in Kelvin's case, blood) into them. Mika had been anuric for two weeks. His body was swollen, and he was dyspneic by the time we saw him. Although his lungs were perfectly clear, Mika had been misdiagnosed with "pneumonia" and given ineffective antibiotics at two previous clinics. If we were in a major pediatrics ward in Boston, three deaths might sound terribly sad but perhaps not unexpected. However, our small hospital only had seven pediatrics patients when three of them died.

Maseno Mission Hospital is located at the end of a long, rutted, uphill road. In the past several years, small public/private medical stations and government "sub-district hospitals" have sprung up along the highway below us. Most are sparsely-staffed by poorly-trained employees who have even fewer available medications than we do. But they call themselves clinics, and they are more accessible than our outpatient department. Sick people cannot easily walk to MMH for care, and poor sick people cannot get to us by any other means -- although some do try by boda-boda, piki-piki and even wheelbarrow. As a result, we are seeing increasing numbers of patients (most often, children, because they get dehydrated so easily) who are too sick to save. We have neither ICU equipment nor staff. Yes, I am upset; and, yes, I am angry. Above all, I am saddened by the broken "system" that provides an inadequate education for clinicians, zero funding for mission hospitals or even road repair, and absolutely no safety net for people of little means.

Keep watch, dear Lord...

Rusinga

I confess I've been island-hopping for two days on Lake Victoria. Friend and neighbor Judy kindly invited me to Rusinga to meet her family, visit the fishing village of Leanda/Olugi, and pay my respects at Tom Mboya's grave.

We traveled to and from Mbiti via matatu, ferry, piki-piki and a hearse named "Beauty for Ashes." (Honest. Replete with casket and recorded gospel music.) Then we spent two wonderful days with two wonderful people. Veronica and Mike welcomed us into their home and their lives -- and into the lives of their extended family.

We walked their large, lush, hippo-holed shamba by day and ate delicious kuku, tilapia and Nile perch by kerosene lamp at night. We met morning preacher-birds and evening drunkard-birds, helped put the cows out and the chickens in, played with Baby Cornell and made friends with "watchdog" Elsa.

We bathed in water carried up from the lake, then heated over an open fire. We watched the twinkling lamps of the lake fishermen after dark, and we mourned with the community when ten of its members died. All had been passengers in a small, overloaded boat that capsized on a windy night last week.

We also prayed. We prayed together before meals, before bed and at Tom Mboya's mausoleum. Veronica brushed away tears as she told us a painful and unexpected story at the serene gravesite.

In 1968, at the age of 18, she became Mboya's junior secretary in Nairobi. It was her first job. One year later, on a quiet Saturday morning in July, Mboya returned from an economic development meeting in Ethiopia, opened his briefcase and presented his small secretarial staff with token gifts. A few hours later, he left the office to do an errand and never returned. Tom Mboya was murdered on Moi Avenue, a major thoroughfare in downtown Nairobi. (Note the bullet-shaped mausoleum roof.) Veronica's quiet words were triggered by the sight of bloodstains on that same briefcase in the memorial hall the site. Her grace, grief and powerful memories deeply moved us all.

It was a blessing to be on Rusinga with Judy. From the moment we were welcomed with prayer, to the moments we grieved together in prayer, to the moment we bade farewell after prayer, we felt surrounded by the love of God and the love of our host family.

Now We Are Six

Rotary House is a remarkable place, as any of our former or current guests can attest -- and Emmah is a remarkable hostess! She is now "mothering" six of us with equilibrium: Andrea from Tennessee via Kentucky, Charlotte and Elke from Amsterdam, Sarah from Colorado via Florida, and Jessie (our YASC volunteer) and me from "all over."

We've had fun celebrating a spate of birthdays together recently -- starting with Nan's and Gerry's in October, and "finishing" soon (only because most of us will depart in December) with Jessie's and Charlotte's. Along the way, we've shared a few Kenyan birthday balloons, too. I'm afraid our neighbors are beginning to adopt some of our decadent western ways...
It was Carolyn from the Comprehensive Care Center who first shyly hinted, "I'll be 22 next week, and I've never had a birthday cake." Then Jessie had a small party for Ruth, who cooks at St. Philip's, after which Doracas -- who teaches at the college -- had a party for her own two children. (It was actually Christian's 8th birthday, but 4-year-old Nema needed a celebration, too!)

Emmah explained to me a few years ago, "We don't celebrate birthdays here." Many Kenyans don't know when they were born. Dates of all kinds weren't especially important until NGO funding and computerized forms arrived on the continent. Until recently, most people simply had to invent their birth dates, as I learned firsthand when I tried to document children's heights and weights for a USAID supplemental food program.

A new law in Kenya this year makes birth registration a requirement. The legislation created a real problem for folks born before 2010 who now need birth certificates to enter secondary schools, universities, etc. Implementation of any new law is a challenge, at best, here -- especially in a rural hospital with only three functioning (but as yet un-networked) computers.

Perhaps we can rationalize birthday parties as being the flip side of that "challenge"? In any case, we're saving our biggest and best party for Emmah. Wish her a happy birthday in your hearts on November 9th! (Photo in her birthday kanga and "flowers" were added post-party.)

Love, Medicine and Miracles - from MV to Maseno

Asante sana, St. Andrew's, for your "hands across the sea." We will now be able to purchase more lifesaving antibiotics and painkillers for our hospital patients, thanks to your generous donations!

Prayer

To me, that's always meant "talking (and listening) to God." In private, of course. To my Kenyan friends, that means "talking (and listening) to God everywhere." Even, gasp, in public.

I'm almost as old and almost as shy as Garrison Keillor. I'd venture to say he would wholeheartedly agree that shy persons from the midwest -- perhaps especially those who are transplanted to New England -- do not pray in public.

Except in Kenya. When in Kenya... even shy persons are asked to pray impromptu prayers and preach impromptu sermons. Life and death and love and hate and faith and doubt are so tangible here, there is little privacy about anything.

So I found myself praying aloud at little Joshua's grave site last Saturday afternoon in Darajambili. The simple cross on his burial mound was made of sticks, tied together with a vine. (Sometimes a grave in the family's yard is marked by a wooden cross; sometimes -- but rarely, and only at much more affluent homes -- it is marked by a cement one.) We stood silently in the sunshine for a few moments afterward, bound together by our love for a very special child.

You may remember Joshua. He was a beautiful boy who was brought to the hospital by our friend "Saint Desmond" from Christ's Hope. Dr. Hardison treated him over the course of many months. (See photo.) We came to know Joshua and his family well. When his massive skin infections began to heal, he was taken to another hospital for surgery to address his contractures because we have no surgeon in Maseno. Joshua survived the operation but died soon afterward. We do not know why. We rarely get any follow-up on patients. The whole community grieved with Joshua's family, and hundreds of people attended his funeral in July.

Since I was on home leave at the time, Linet and I traveled together last weekend by matatu to Darajambili (and many more kilometers past the junction, on foot) to pay our respects to Mama Joshua. We were greeted warmly and spent an hour reminiscing about Joshua, amidst tears and smiles. Just as I thought we were about to depart, several neighbors appeared to help Mama Joshua serve us a very large, very traditional, very delicious meal of ugali, sukumawiki, curried eggs, cabbage, salad, beef, "soup" (broth) and chicken. And oh, yes, some rice for the mzungu. But first we prayed.

Afterward, everyone (neighbors and family alike) moved to a large mat made of reeds that was placed beneath the shade of acacia trees. We shared even more stories about Joshua -- in Luo, Kiswahili and English. His young life was an all-too-brief blessing to everyone who knew him. Linet and I watched children and chickens and puppies and kittens play at the Luo homestead for another hour before we apologized for needing to get back to the hospital. Mama Joshua put her arms around me: "Asante sana," she said. "You came all the way from the U.S. to pray with us." (I really just came from Maseno.) Neighbors gathered to bid us farewell. But first we prayed together again.

We may sometimes be surrounded by grief, but we are always surrounded by prayer. It is I who must say and pray (both silently and aloud), "Asante sana." Especially on All Saints' Day. Thank you, God, for giving us Joshua as long as you did. Thank you for holding him, the saints who have gone before -- as well as those who live among us still -- and every one of us in your loving arms.