Tuesday, September 1, 2009

Eldoret to Lamu, Lamu to Home

The Saturday before flying home, our group of medical students headed to Lamu for a mini vacation to wrap up our time in Kenya. The medical student who came at the beginning of August--Elisa--also came with us, but she went back to Eldoret afterwards instead of coming home. Lamu is a Kenyan island located about 80km off the coast of Somalia, which is very close to prime pirate/terrorist territory. For that reason, I decided not to blog about where I was going until after I had returned home. I figured I'd be a good daughter and spare my parents the heart attack!

Our trip to Lamu was amazing. It is a very quaint Muslim town that has a lot of character. There are no roads and no vehicles on the island, so the only mode of transportation is your two legs or a donkey ride. We stuck to our two legs while we were there since we heard donkey rides can get more adventurous than desired. Aside from being woken up every morning at 4am by the Muslim chants over the mosque loud speaker and hearing the donkeys make interesting noises all night long, it was a very peaceful trip. The beaches are beautiful and we did nothing but relax and walk around town. Lamu has great restaurants right on the waterfront with fresh seafood that is delivered each morning. They also have impeccable juice smoothies that are to die for! All in all, the trip to Lamu was a perfect ending to our Kenyan experience.

Most of the days in Lamu were spent doing whatever we pleased, with no schedule to abide by. We took a walking city tour, laid out on the beach, went for a boat ride, and did some shopping at the local wood carving and silver smith shops. The town was so unique and very welcoming. The buildings are extremely close together, so their "roads" are about 4 or 5 feet wide. It was like we were living in a maze, trying to weave our way in and out of tight spaces. Lamu is famous for its dhow boat rides, during which you can view a sunset, go snorkeling or fishing, or visit the ancient ruins that are located on a separate island nearby. We took an afternoon boat ride out to see the ruins and caught a sunset on our way back. It was such a relaxing afternoon!! There's nothing like kicking back in a boat with a few friends and setting sail in Africa. The scenery was absolutely gorgeous, and I felt so small while sitting on top of the Indian Ocean.....a feeling I mentioned in my earlier posts that I love.

I've posted some pictures from our trip to Lamu here for you to see. I hope you find it to be as beautiful as I did. It was so nice to end our time in Kenya with a yet another trip that took my breath away. If I could pick an overall theme to my journey through Kenya, that would be it....it was absolutely breathtaking.

Well, after 39 hours of traveling, I made it back to Indianapolis this past Thursday, safe and sound. On Friday, I went up to Fort Wayne to visit my parents, and my brother Sean came in for the weekend as well. Though I could hardly believe that I was back in the U.S. and my time in Kenya had come to an end, it was so nice to see them after being half way around the world. No matter how much I enjoy spending time abroad, I agree wholeheartedly with all those who say 'There's no place like home.'

After getting a few short days off, I started my new rotation today with the Pediatric Infectious Disease team at Riley Hospital for Children here in Indianapolis. Though I'm looking forward to returning to normalcy and starting an exciting month filled with residency applications and college football, I'll definitely miss being in Africa. My trip there was a dream come true--something I had yearned for for a long time now--and I consider myself blessed to have had the opportunity to make the journey. Thank you to all of you who have supported me in years past and especially over the last two months as I ventured overseas. Your emails and words of encouragement gave me strength when times got tough, and I could not have pushed through without them. I hope you enjoyed reading my blog while I was away. I look forward to sharing my stories with all of you in person now that I am back on U.S. soil!!

Asante sana! (Thank you very much!)

God bless each and every one of you, now and forever.

Monday, August 31, 2009

Kerio View

During my last week in Eldoret, a few of my Kenyan friends and I decided that we wanted to go out to lunch for one last hurrah. I gave them some times that I was available and told them to pick a place---and boy did they pick a place!! I was anticipating going to some Kenyan restaurant in town for an hour or so, but little did I know, they had an entire afternoon planned in my honor! We went to a place called Kerio View, which is a very nice hotel that overlooks the rift valley. It's about a 30 minute drive outside of Eldoret. We left town around 1230pm and first headed to a "view point" where we could take in some sights. The five of us climbed up on some huge rocks where we sat for an hour or so, making small talk and marveling over the breathtaking scenery. Then we made a leisurely 2km stroll over to Kerio View for lunch. The hotel restaurant was beautiful. It was very quaint and was encased in glass along the back side, which overlooked the rift valley. We took in a tasty Kenyan meal and thoroughly enjoyed each other's company while doing so. When we were done eating, we walked around the grounds of Kerio View for an hour or so before heading back to Eldoret. A little bit of hail and rain slowed down our trip home, but when all was said and done, we were home by about 645pm. It was a wonderful day, and I was so happy that I was able to spend some quality time with my friends before I left for home. I've posted some pictures of my day at Kerio View to give you a better idea of what it was like. My four Kenyan friends are medical students from Moi University that I met my first day on the wards, as they were part of my medicine team. Their names are Ken, Odhiambo, Injere, and Nuru (Nuru is the only girl). They are incredible people, and I've really enjoyed hanging out with them. All of them live in the hostel, so I've gotten to see them quite often. I was so fortunate to have made such good friends while I was here. I'm hoping that some of them get to come to Indiana next Spring with the IU-Kenya exchange so that I can see them again. I'm definitely going to miss them when I go home!!!

That's about all for the Kerio View update. I should have one more post before I wrap up my blog. As always, thanks for following! God bless everyone.

Friday, August 28, 2009

Last Day on the Wards

My last week in Kenya was somewhat crazy. A lot of different things happened that I want to share with all of you, and rather than write one really long post, I've decided to split things up into shorter segments. So I'll start with my last day on the pediatric wards, which was definitely a day I will never forget.

My last day on the wards was last Thursday, and I had gone into the hospital that morning expecting rounds to be short and sweet because we only had two patients. Our team was very small that day--just our intern, resident, one medical student, and me--which was a nice change of pace. As expected, we were done rounding by 930am, and I was ready to do some last minute 'chores' to wrap up my two months at Moi Hospital. What I didn't know was that something else was about to happen....something that I certainly had not planned for.

Just as we were close to being done rounding, a new patient was admitted to our ward. We saw a mother walk in with her 10 month old girl in her arms, who appeared to be pretty stable on first glance. As is typical, the nurse proceeded to get the new patient situated in a bed before we came over to see her. My resident had planned to fully assess the child with me once we were finished rounding on our last inpatient. However, that plan changed about two minutes after the child got to her bed, as the nurse came running over to us, saying that we needed to come see the baby.

When we got to the little girl, she was not breathing. She was lying lifeless on the bed. We checked for a pulse, and when we found that she had none, the resident, intern, and I started CPR. It took a minute or so to get an ambu bag, but once we did, we found it hard to get any air into the baby's lungs. It seemed that she was full of secretions that were blocking her airway. We asked the nurse to quickly get us some suction, but as is the norm at MTRH, it took several minutes before a suction machine made it to us. By the time it arrived, it was too late. The baby had been without a heartbeat and without any oxygen for too long. Our resuscitation efforts had failed.

That was the first time I had lost a pediatric patient after actively participating in a rescucitation attempt, and I'm sure that I will never forget that day. We still don't know what happened to the little infant, but we suspect that she somehow aspirated after breast feeding. I still maintain that we could have saved her if we had the right tools closer by, but that's something I will never know.

After we consoled the mother and walked away from the little girl's bed, the Kenyan medical student on my team turned to me and said something that struck me. He said, "I worked at Wishard [in Indianapolis] for 6 weeks and we had one death the entire time--and it was a big deal. Here, this type of thing happens multiple times a day, and it doesn't phase anyone." That particular medical student had spent part of his 5th year of medical school working at Wishard Hospital in Indianapolis as part of the IU-Kenya exchange program. Thus, he knew how things worked back home and how much it differs from Kenyan medicine. His comment is one that many Americans had made before, but to hear those words come from a Kenyan was different. He made me realize that even though death is so widespread amongst the wards at MTRH, it does have an effect on the physicians and students there, which is not something I was sure of before that day.

As you can tell, my last day on the wards was not what I had anticipated. It definitely caught me off guard, but looking back, it was a great learning experience. It was humbling, to say the least, and I will always remember the way I felt that day.

*I've posted a few pictures of the pediatrcs ward for you to see. The last picture is one of a patient with chicken pox that was on our ward. He was adorable, but definitely had a bad case of the pox!!

Wednesday, August 19, 2009

Odds 'n Ends

Well, not much exciting is happening here, so I will spare you all the boring details. Being that it is my last week in Eldoret, I'm just trying to prepare myself for our Saturday morning departure. Between rounding in the hospital, going to lectures, and making some last minute pitstops at some of the local shops downtown, my schedule has left me with little time to breathe. Tomorrow and Friday will be no different, as I still have several things that are not checked off on my "to do" list. Hopefully all will go smoothly and everything will get done by dusk on Friday!

I just wanted to write to share a funny story with you. Over the past two weeks, the new medical student, Elisa, and I have adopted a morning run as part of our repertoire. It has been awesome. We get up around 615am and leave the hostel at about 620am, just when the sun is starting to creep up. We run for about 35-45 minutes along the dirt paths that lie next to the somewhat paved road. Seeing the sunrise every morning in Africa has been a great way to start the day, and it is definitely something I will miss when I get back home.

So here goes the story. This past Tuesday, Elisa was not feeling well, so she decided not to make the run that morning. Deciding to stick to our newly established routine, I made the journey myself and enjoyed yet another beautiful African sunrise. After I had finished my run, I walked up to IU house to shower quickly before lecture. On my way back to the hostel, a Kenyan man (though lighter complected than your typical Kenyan) started briskly walking towards me, yelling "Excuse me, madam, excuse me." I stopped and asked how I could help him, to which he replied with a huge grin on his face, "Are you from Bombay?" Chuckling, I answered him "No sir, I'm not." He then questioned me, "Where are you from?" When I told him I was from the United States, he looked at me in amazement and said, "You're KIDDING me!! You look JUST like a Bombay-ite!" This statement caught me off guard, coming from a Kenyan man. Laughing again, I assured him that I was from America. I did, however, throw him a bone and tell him that my dad was from India. His eyes lit up, and he proudly told me that he had been to Bombay. After I told him how great it was that he had visited there, he jumped into a 5 minute monologue about how I really did look like a Bombay-ite. When all was said and done, this guy ended up taking about 10 minutes of my time, which I thought was pretty impressive given the nature of the topic.

Anyway, I thought everyone would enjoy this story, knowing how confused people consistently get about my racial descent. I didn't think there would be as much controversy about my heritage here in Africa since I definitely don't look African, but I am routinely proved wrong. Every 2 or 3 days, I manage to get questioned about it in some way or another, and most people find it hard to believe that I come from the United States. It's become a running joke here, just as it is with all of my friends back home. To be honest, it's actually kind of refreshing.

I hope everyone continues to do well. I officially leave Kenya to head back to the States one week from today. I'm hoping to get one more blog in before I leave Eldoret on Saturday, but I'm making no promises. As always, thanks for following my journey. Please take care. God bless you all.

Friday, August 14, 2009

Newborn Unit

As promised in my last post, I wanted to take some time to write about my experience in the Newborn Unit this week. I don't have any pictures to upload at the moment, so I apologize for that. Maybe I can add some next week once I take them.

The Newborn Unit at Moi Teaching and Referral Hospital is housed in a beautiful, brand new building called Riley Mother & Baby Hospital. For those of you who have ever heard me talking about IU's children's hospital back home, you may remember that it is called Riley Hospital for Children. The mother & baby hospital here in Eldoret was funded by groups from Riley in Indianapolis, so it was given the name Riley as well. However, it is called mother-baby for short. The hospital was just opened earlier this year and has helped improve perinatal and postnatal care for women and children all throughout Kenya.

Caring for neonates can be very intimidating, and in the United States, the NICU tends to be somewhat of a dreaded rotation. The babies are so tiny and extremely sensitive, meaning that you must be very careful when ordering things for them, even if it's something as small as IV fluids. Before starting my week's rotation through the newborn unit here in Eldoret, I was a little hesitant and didn't know what to think. However, I quickly learned something about neonatology that I wasn't expecting....I love it!! Treating the newborn babies is unlike any other type of medicine that I've experienced. Even treating infants and toddlers is very different, so I really like its unique nature. Caring for the neonates also involves a lot of calculations when figuring out how much to feed them. Anyone who knows me well knows how much I love math, so it should come as no surprise that I enjoy playing with numbers on the wards. Lastly, doing a physical exam or drawing blood on a baby just slightly bigger than my hand can be a little nerve-racking at first, but it actually is quite enjoyable now that I've gotten the hang of it. All of these factors added to my enjoyment in the Newborn Unit this week. I guess I'll just have to wait until I rotate through the NICU during residency to see if I like it as much back home! After all, there are a lot of differences between the units here in Kenya and those in the States (i.e. there are no ventilators here), so I may not end up liking it as much in the long run.

Naturally, during my week in the newborn unit, I fell in love with one of the babies there. Though there are so many kids here in Kenya that I would love to bring home with me, this one defintely takes the cake. He is so precious, and I wish that I could take him back to the United States with me and give him a good home.

This baby's story is definitely a sad one. He was brought to the hospital by the police, who found him on the side of the road outside an elementary school. He is a very healthy baby--just a little bit on the small side. The name on his chart reads "Abandoned baby Abraham". Though we care for abandoned babies quite routinely at our hospital, this child's story is unique. Since his admission, we have tracked down his mother, come to find out that she is in prison. In the United States, the correct way to handle this baby's situation would be to contact the mother and see if she wants to keep the baby. If she did, the baby would probably be put in foster care until mom was able to care for him. In Kenya, the situation is very different. If mom were contacted and states that she wants to keep the baby, Kenyan law states that the baby must be sent to prison to live with mom. If mom expresses no interest in keeping the baby, it is put up for adoption. From the experience of the physicians at MTRH, most of the children who are sent to prison to live with a parent end up coming back to the hospital sometime later with severe malnutrition. A majority of these kids end up dying.

This situation really got me thinking this week. The head physician in charge of the Newborn Unit right now--who, in my opinion, is very, very good--made the decision to put in the chart that the mom was contacted and stated that she didn't want the baby, though the mom was really not contacted. The physician was certain that this 3 pound baby would never survive in prision and thought his only chance at life would be adoption. What an ethical dilemma!! On the one hand, it seemed like the correct decision to keep the baby out of prison, where conditions would be grim at best. On the other hand, our physician's decision is one that will separate the child from his biological mother forever. Who is she to say that that is what's best for the child?? And on a different note, why does Kenyan law mandate that children in this situation be sent to prison in the first place?? All of these questions have been racing through my mind throughout this week, but I've finally come to the realization that it is a lose-lose situation. No matter what, Abandoned baby Abraham will suffer in some way, and some form of ethical conduct will be breached. In the meanwhile, he remains in our Newborn Unit, cute as can be, just waiting for someone to love him. As the plans currently stand, he will be put up for adoption once he gains a little bit more weight.

Well, that's all I've got for you from the Newborn Unit. Next week, I head back to my pediatric team on the wards. I'll miss being with the neonates, but I really enjoy the pediatric side of things at MTRH. This will be my last week here in Eldoret, after which we'll take off to do some traveling before heading back home. I can't believe I'm down to just one more week. I'll be sad to leave, but I'm definitely getting excited to get home and talk to all of you. The one thing lacking in Africa is my family and friends.....as the saying goes, there's no place like home!

I miss and love you all. Take care and God bless.

Wednesday, August 12, 2009


Well, a lot has happened since my last entry. I apologize for the lack of updates lately, but it is much harder for me to get on the internet while living at the hostel. Several events occurred last week that I want to comment on, so bare with me. I’ll try to keep it concise.

Last Wednesday, I got an opportunity to visit a local orphanage. It was an orphanage for HIV positive and HIV exposed children that currently has 34 residents ranging from 6 months to 12 years. The orphanage was started 4 years ago by a wonderful gentleman named Joshua. None of the children are able to be adopted out, meaning that the kids are kept until they are at least 18-years-old and are ready to fend for themselves in the real world. The kids at the orphanage are adorable, and I found it very difficult to walk away from them at the end of the day. One boy in particular – Eric – would not let go of me. He climbed into my arms shortly after we arrived and stayed there for hours. Whenever I would try to put him down, he would cling on tighter. Even if I let go completely with my arms spread out wide, he was still attached to me by his strong embrace. I wanted to bring him home with me so badly! I’ve uploaded a picture of him and me for you to see.

On Friday of last week, I went out in the field with a worker from a program called Orphans and Vulnerable Children (OVC). Affiliated with AMPATH, OVC exists to look after children who have been orphaned or are in a vulnerable state that could leave them as orphans at any moment (i.e. children who’s parents are very ill). The OVC workers visit the homes of these children, do a home assessment, and provide them with resources to help them cope with their living situation, whatever it may be. OVC strives to treat the children in the home as opposed to removing the children and placing them in foster care. This approach promotes family living and helps decrease the amount of children who are separated from their families.

For my field visit, we went out to a rural area called Mosoriot just out side of Eldoret to see a 4-year-old girl named Ivy. Ivy was abandoned by her mother, who had recently found out that both of them were HIV positive. The mother, who is one of eleven children, was ashamed of her HIV status and the fact that she gave it to her daughter, so she left her child and fled town. In other words, Ivy’s mother was self-stigmatizing – a concept that is rather common in HIV infected patients in Africa. All of her siblings and parents are supportive and accepting of her HIV status, but she is so ashamed that she feels she must separate herself from her family. Thus, she left Ivy with her parents (Ivy’s grandparents) to be raised. When we visited the home where Ivy lives, it appeared that she was being well cared for. Though we did not get a chance to meet her because she was visiting one of her aunt’s in Eldoret during the school holiday, it seemed that Ivy received a lot of love from her grandparents, aunts, and uncles. The home seemed very sanitary and well equipped with living supplies (i.e. food, water, shelter, bedding, etc.), so we had very little worries about the safety of this child. If it had appeared that Ivy was in need in any way (i.e. malnourished, in need of clothing or bedding, etc.), OVC would have help provide what was lacking in the home. I have posted a picture of Ivy’s home and the roads that we took to get there. It was located in a beautiful countryside, somewhat “off the beaten path” (though most homes in Kenya would be considered to be “off the beaten path” by American standards). The second picture is of the neighbor’s house, but it gives you a better perspective of the area we were in. It was gorgeous landscape, though getting there was a slow and bumpy ride!

The last thing I wanted to talk about was the weekend trip I took to Lake Naivasha, which is about 3-4 hours southeast of Eldoret. A group consisting of myself and four other medical students (we gained one more IU medical student last week who is here for the August-September rotation—her name is Elisa) left for Naivasha on Friday afternoon with plans to visit Hell’s Gate National Park on Saturday. Hell’s Gate is a park with great wildlife and beautiful scenery. One of the appeals of it for us was that there are no predators there, so we were able to rent bicycles and bike through the park as opposed to driving around all day. There is also a gorge at the far end of the grounds, which can be hiked through. It's actually the same gorge where the movie Tomb Raider was filmed. I've never seen the movie, but the gorge was an awesome sight to see!! I've uploaded some pictures of Hell's Gate, so I hope you enjoy them. There's also one of a baboon sitting in the tree at the camp we stayed at. Just a forewarning though, the pictures definitely don't do it justice!!

Well, that's all I have time to update for now. I'm rounding in the Newborn Unit this week, which Kenya's closest equivalent of what would be called a Neonatal Intensive Care Unit in the United States, so hopefully I'll be able to post more about my experience there sometime tomorrow. Only two weeks until I leave to come home. Time really flies when you're working in Africa!!!

I hope all is going well in the States. Much love to everyone. God bless.

Tuesday, August 4, 2009

Street Kids

This past weekend I played soccer with some Street Kids here in Kenya. It was an amazing experience. Street Kids are kids in Eldoret that help their family earn a living by working in the streets. They run around downtown and beg people for money or food. At the end of the day, they bring all that they have accumulated home to their family. The lifestyle of a Street Kid is very unhealthy. They do not go to school, so there is not much room for advancement when they grow up. Similarly to homeless or inner city children in the United States, these kids often find themselves developing bad habits. Here in Eldoret, huffing glue is extremely common amongst the Street Kids. The glue is highly toxic and has potential to cause brain damage and vision loss if used long-term. When asked why they huff glue, most street kids say that it helps them forget all the hardships they have in life.

A few people from IU in conjunction with some local Kenyans are starting a program called the Tumaini Project in an attempt to transform the lives of Street Kids. Tumaini means "hope" in Swahili. The primary goal of this project is to get Street Kids off of the streets and into school so that they can develop skills necessary to get a job in the future.
The Tumaini Project is in its initial stages, so fundraising has just begun in the United States. Its leaders hope to raise enough money to build a few centers where Street Kids can go to learn and play. In the meanwhile, several small activities are being instituted for the kids. One is a twice-weekly soccer game, which I participated in on Saturday. We went out to the barracks where the Street Kids live and played soccer with them in the field. There were approximately 40 kids in a 40-yard space, so it was mass chaos. I really enjoyed it though. The kids were unbelievably nice and welcoming. It was fascinating to interact with them in their own setting, as opposed to being approached by them on the streets of town. They were so different at home, and in a way, they regained their innocence when I saw them on the soccer field.

After the soccer game, the leaders of the Tumaini Project bought some milk and a loaf of bread for all the kids who participated. The idea behind this exchange is the following: Taking time to play soccer means that the kids lose time on the streets, and therefore, do not have anything to bring home to their family. Thus, if the kids have an incentive, they will be more willing to get off the streets and play.

In the upcoming months, the Tumaini Project will be starting health care for Street Kids. Medical students, residents, and physicians from the IU House will volunteer their time once or twice a week to provide check-ups as part of the mission to introduce the kids to a healthy lifestyle. This program has already made great strides since I’ve been here, and I can’t wait to see how far it progresses in the next year or so. It was a pleasure participating in the event this past weekend, and I plan to attend as many events as possible in my last three weeks here.

I’ve posted a few pictures for everyone to see. There is one of the barracks next to where we played. It is a picture with a few tall buildings, and just in front of the buildings you will see some shacks, which is where many of the kids live. There is also a picture of a couple of street kids huffing glue. They walk around with the glue stuck to their lip – it’s actually pretty amazing how they get it to stick there for so long. There are a few pictures of us playing soccer. The other Mzungu (aka white person) is Ryan, one of the other medical students here with me. Notice that a lot of the Kenyans play in khaki pants, dress pants, loafers, boots, bare feet….whatever they have. Also notice that the field is filled with potholes, rolling hills, small shrubs & trees, and rocks. I found that 90% of my concentration while playing was dedicated to trying to stay on my feet! The last picture I posted is of the road that leads up to the barracks where some of the Street Kids live. You can see shacks on the left and the dirt road in the middle.
I hope everyone enjoyed my story about the Street Kids. Working with them has been a memorable experience – one that I will hold close to me for many years to come.

I love and miss you all. Take care and God bless.