My heart

In less than a month, I'll be returning to Kenya.  It was only 3 years ago that I was preparing for my first trip to Migori.  That trip brought a lot of firsts:  I had never been to Africa, never traveled that far away from home.  I had never volunteered as a nurse anesthetist.  I was full of hope, excitement, nerves and anticipation.  What would the reception of our presence be by the locals?  What kind of equipment would we be working with, what drugs would be available - would I be able to provide anesthesia safely?  Where would I sleep at night?  What would be the condition of the restrooms?  I worried about safety.  Worried about getting sick so far from home.  Wondered what individuals would make up our team and how we would work together as a team with only just meeting.  How would I be able to communicate effectively to my patients when we speak different languages?  So many unknowns and yet, somewhere in my gut, I knew I had to go.  Intuition plays a huge role in my life and the paths I choose to take.  My gut said "GO".  So glad I listened.

Preparation for that trip meant getting 7 immunizations (ouch!), filling multiple preventative prescriptions, buying personal and anesthesia supplies, stocking up on bug repellant, sunscreen and OTC medications to treat anything I could possibly catch "in the bush".  I packed enough protein bars, nuts, granola and other snacks to keep me fat and happy (really - I could've fed a 5 person family for a month with all the food I took) in case I couldn't stomach the meals provided.  I searched endlessly online for articles and blogs on providing anesthesia in third-world countries, peppered our team leader with countless questions, and asked everyone I knew if they had ever done similar work.

It is incredible to look back and think about that trip.  Those 10 days changed my life, changed my perspective on the world and my role in it.  I left my heart in Kenya February 2012.  I have been blessed to continue this work and have visited my heart 5 times since.  Each time I go, it gets harder to leave.  I have formed strong relationships with our Kenyan staff and our sweet orphans.  I am a proud "Mama" to two beautiful, bright twin girls.  I have lasting friendships with the individuals on each team I have served.  I keep trying to figure out a way that I can stay for longer periods of time, but for now, am visiting when I can, for however long my job and finances allow.

Thank you all for you joining me on my journey.  I could not do it without the love and support of my family and friends.  

Safari Pics

Here's just a few safari pics. More to come later. The giraffe pic is blurry but I like it because it looks like he's smiling =)

Masai Manyatta Pics

Safari!

Wow! What a full day!!!! The Mara did not disappoint!!! Before we even entered the gate, we saw zebras and topi. But I'm getting ahead of myself.....

It took us a couple of hours to get to the gate of the Mara. On the way there, we stopped at a Masai manyatta (village). I have truly never experienced anything like it. The view that these villagers have of the Mara is unbelievable (see photo below). The Masai wear a wrap calleda shuka for their tribe that is bright orangey-red and purple - it complements their skin so perfectly. Their traditional dress is very elaborate with bead necklaces, earrings, and headdresses. Peter was our 'tour guide'. He showed us around the village and taught us of life there. The Masai believe they own all the cows in the world and each individual Masai village care for hundreds of cattle. To protect their flock from the predators, they build a fence around their homes and bring their animals inside the walls each night. This equal poop everywhere in the village. And where there is poop, their are FLIES. I have honestly never seen so many flies in one place!!! It was really gross. You swatted in vain. There was no way to keep them off of you. It was pretty uncomfortable.

The Masai live off the cows blood and milk. As their guests, they wanted to share cow blood with us - here's how it goes: they round up a cow, put a rope as a tourniquet around the cows neck to distend the jugular, then they take an arrow and puncture the vein.... They fill a charcoal lined (to kill the germs-ha) gourd with the blood then pass it around for you to drink. Sound appealing? Did I mention the flies really like the blood too? Although I did not partake (I'm not crazy!) some of my teammates did.... I took a video of the ceremony and will post it if I can.

We are staying at the Mara Serena Lodge. The pic below is taken from my bedroom balcony.... Breathtaking! The hospitality here is great and the food is wonderful! I highly recommend it!

On our game drive this afternoon we found a pack of lions resting by a ginormous dead hippo. The lions were spectacular! We were REALLY fortunate to see THE Big Daddy Lion King as well - isn't he beautiful?! I couldve watched them all day. Watch the video - super cool!

I kept saying that each animal was my favorite as we cam upon them.... It's really hard to choose a favorite when they are all so beautiful and unique. So fortunate to see them in their natural habitat. It was a great day and I'm off to dream of riding an elephant. Nite!

2/20-2/22

Clinic

Kenya Relief holds three days of clinic every week there is a team in Migori. Clinic days start early and run late. Many patients come from all over Kenya - I met a lady who traveled eight hours to see the doctors from America. For some, we are their only hope for treatment.

For myself and the majority of my teammates, it was our first time to serve with Kenya Relief. We all had to think outside the box and step out of our comfort zones. Although most of us had just met and had never worked together, we shared a common goal: to help as many people as possible in our short time here. I felt our team worked really well together from the word 'go'. In three days, we treated over 500 patients and performed 25 surgeries. An excellent group of ENT surgeons from Harvard university did a superb job removing many enlarged thyroid glands (goiters) in a setting that was completely unfamiliar to us all.

Every anesthetist knows patients with large goiters can be some of the most challenging airways to manage. As you can see in the pictures, these patients had MASSIVE goiters. Although their were two patients that we were unable to intubate, every patient was safely managed. I was proud to be apart of such an outstanding group.

In America, we have so much equipment and supplies at our disposal. I was impressed by what equipment we did have in Migori (thanks to generous donations). We had fully functioning anesthesia machines (with scavenging running out the window), suction, bovie cautery, and even an air conditioning window unit. Back home, we use a monitor called a capnogram that measures the amount of each gas being exhaled by the patient. We did not have a capnogram at the clinic so we had to use other data to ascertain the depth of the anesthetic being delivered. This was an intimidating challenge at first but I feel everyone adjusted quickly and became fairly comfortable without the monitor.

Power at the clinic comes from a large generator that was graciously donated. I now know it is not a question of IF the power will go out, it is WHEN. The first day of clinic, we had multiple power outages which presents many issues in the operating room in the middle of surgery. Without power, you are unable to deliver anesthetic gases or look at the patients vital signs on the monitor. Most of the time, the power was only out for a few minutes at a time, but we did have one instance in which the power was out for at least 25 minutes. I was impressed because everyone in the OR kept their cool. We held flashlights over the field and the surgeons continued to do what they could without power. Molly and I had brought our precordial stethoscopes which allowed us to monitor the patient by listening to their heart tones and breath sounds. We placed a portable blood pressure cuff on the patients' legs and gave bumps of propofol to keep the patient asleep. It was an experience to say the least. =)

This week, I have experienced a roller coaster of emotions - joy, overwhelming sadness, love, anger, hope, helplessness, shock. One patient in particular had a huge impact on me. Her name was Velma. Although her mother claimed she was six months old, she looked no older than a month or two. She was extremely malnourished and what we in the States would consider 'failure to thrive'. The more we learned of this baby's story, the sadder it got. Her mother was twenty years old, HIV positive, and had already had one baby die. It appeared as if she herself had been eating well... She claimed to have been trying to feed Velma porridge. This situation angered me. Velma will eventually die. Even if she happens to not have HIV herself, she has not had adequate nutrition to develop properly. I am angered so because this situation will repeat - it happened to Velma's sibling and will continue to occur. Depending on how the mother's disease progresses, she may have many more children in her lifetime. This is just one story out of one million. I am certain there are thousands just like Velma. I think of my sweet, healthy, chubby nephew, of how fortunate we all are and we had nothing to do with it. You do not pick where you will be born. Every child deserves a chance at life. It is so unfair that some on this planet have so much while so many go without.

I am thankful that we were able to help so many people in the community this week. I am humbled by the spirit of the people of Kenya. If only we could learn from them, we could have much fuller lives and live contently instead of always wanting more. One of my friends favorite quotes keeps resonating with me - "I am a part of all I have met" - Velma will always be apart of me as will many others here. I believe this experience changes you, changes your heart, changes your thinking, hopefully changes your actions. I plan to continue to do what I can to make conditions here better. I hope to open your eyes to life here so you will do the same.

Now, we head to the Masai Mara for two days of safari. It is dawn and we should be in the park in a couple of hours. Still can't believe I am here. Someone pinch me.

Sunday, Feb 19