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.

Saturday, August 1, 2009


I just wanted to upload a few pictures for everyone to see. There is one from inside the hostel, where you will see John and Marissa standing. That is the boy's room, and you can see the room in its entirety from the picture. There is one from outside the hostel, one from outside the hospital, one from the medicine wards, and a couple from in town. Hopefully this will give everyone a better idea of where I'm living and working. I will take more from the hospital, but this is all I have for now. Enjoy :)

Friday, July 31, 2009

Week in Review

Overall, this week went very well. It was probably my best week in the hospital since I arrived in Kenya. I am loving working on the pediatrics ward and interacting with the medical students and residents on my team. Though it can be tough being the "foreigner" in the hospital at times, I am learning a lot and managing to build good relationships with some of my patients. It's always a nice feeling to walk into the wards in the morning and have my patients smile with excitement at me, despite the fact that I cannot speak to them in their language.

I knew last weekend when I saw a Kenyan walking in town with a Notre Dame t-shirt on that this would be a good week. It made me so excited to know that the Kenyans are Irish! I think it made my week, and I can't believe that I haven't blogged about it until now!

When any of us North Americans are running or walking around Kenya, we often get "Mzungu" shouted at us by the locals. Mzungu is more or less the swahili way of saying "white person". It would be the equivalent of getting called a "gringo" when you travel to Central or South America. I occasionally get "Indian" shouted at me...as a matter of fact, when we were running, one of the locals yelled out "two mzungus, one Indian". I'd say he was pretty accurate. I went running a few weeks ago with two medical students from back home. It's not uncommon for Kenyans cheer for us from the streets or even to come off the streets and start running with us. So there was one guy - probably about 20 years old - who got up from sitting in his yard and started running with us. Three miles later, he was still there! At one point, I was running in front of him, and he made the comment that I run like Cristiano Ronaldo. For those of you who don't know, Ronaldo is currently one of the best soccer players in the world. I just laughed when he said it, but it was definitely the highlight of my run!

I guess it's worth mentioning that I moved over to the medical student hostel this past Monday. It's a very interesting place. It's not the most sanitary, but it's do-able. Your cockroach radar just needs to be very, very high! Marissa and I are starting to become cockroach killing pros--a skill that I hope I don't need when I get back to the States. There have been multiple rat sightings in the men's bathroom on the first floor, but the female bathrooms have been spared thus far. I'm hoping that the rats do not figure out how to get up to the third floor anytime in the next 3 weeks! I actually like living in the hostel better than IU house because it is more cultural. All the Kenyan medical students live there, so we get to spend more time with them. Our rooms are tiny - probably about 6 feet x 8 feet with two people per room - but they are adequate for sleeping. Being in the hostel, we no longer get free meals at IU house, so we are responsible for finding our own food. This has been good for us, as we've been able to eat local Kenyan food in the hostel cafeteria and in restaurants throughout town. All in all, it's been a good experience, and I think I will enjoy my remaining time there.

Anyway, nothing too exciting is really happening. Just a lot of working in the hospital lately. I realized the other day how much I wish I could be sharing this experience with my family or great friends. Of all the places I have traveled internationally (Brazil, Argentina, Uruguay, Honduras, Kenya, Uganda), I have never gone with anyone that knows me well. I think it may be time to change that. Mom & Dad, Brian & Sean, I wish you were here. This is a beautiful place, and with my guidance, I think you would enjoy it. I hope to explore the world with all of you someday, starting with Italy next year!!

Thanks for following my journey thus far. My half-way point has come and gone, and in just over 3 weeks, our group of four will begin making our way back home. Please let me know if there is anything you would like to hear more about. I hope to post pictures of downtown Eldoret and the hospital soon, so be on the lookout! Please take care and know that I am thinking of all of you every day. Hugs and kisses. God bless.

Monday, July 27, 2009

First Day of Peds :)

I started pediatrics today, and I think I'm going to enjoy it much more than medicine. Although I wasn't able to round with my team this morning because no one was there (true Kenyan fashion), I got a chance to stand in on one of the other team's rounds. The attending physician on staff for that team was very good and taught a lot to the med students, so I found it to be a pretty valuable couple of hours.

I was touched pretty deeply by one of the patients we saw while rounding on the wards. She was 12 years old and had congestive heart failure secondary to rheumatic heart disease. She was incredibly sick and appeared very malnourished. But what struck me more than her illness was her social situation. She was the 4th born of 6 children and was brought to the hospital by her older brother, who seemed to be about 15 years old. All 6 children in the family were orphans. Their father had died from tuberculosis, and their mother later died from unknown cardiac disease. After their mother's death, the kids moved in with their grandmother. However, the grandmother subsequently passed away, leaving the children with no family. Thus, they all were made orphans.

Looking into the eyes of our patient and her older brother was heart-wrenching. They looked so helpless. I just wanted to console them and assure them that everything would be alright, but that is not something I can do truthfully. The brother seemed so grown up, and you could tell that he was trying his best to look after his siblings. He stayed by his sister's side every second, and after we rounded on her, I saw him pick her up out of bed and put her in a wheelchair to walk her around the wards. Towards the end of rounds, I caught a glimpse of him folding their extra clothes and straightening up around his sister's bedside. In a way, I felt very proud of him. He was doing everything he could to help his sister--taking medical orders from doctors, keeping his sister comfortable in bed, managing their belongings. But at the same time, my heart went out to him. I can't even imagine how hard life has been for the 6 children in that family. Losing both parents and a grandparent would be hard enough to endure, but having to live as orphans and look after your siblings at such a young age is incredible. I don't know how I would've handled the situation if I were walking in their shoes.

So many children in Africa are forced to grow up before ever having a chance to enjoy their childhood. It's not uncommon to see 7 or 8 year olds here herding cattle or working in the fields with a machete. Kids in the United States are generally care-free, living life without any true worries. Many Kenyans must fight for their lives from the day that they're born and spend much of their childhood figuring out how to survive. It saddens me to see kids living with so much responsibility. I feel like it strips them of their innocence--a trait that I value so much in children. However, most of my feelings are driven by American culture, which is extremely different from that in Africa. Therefore, I'm not so sure that all Kenyans would have the same sentiments as me.

Overall, my first day on pediatrics was wonderful. I enjoyed seeing the wards and meeting some of the patients, but most of all, I enjoyed the feeling that today gave me. It left me excited for the weeks to come, because I know that there is a lot for me to learn and accomplish within the realm of pediatrics in Eldoret.

Much love to everyone. God bless.

Thursday, July 23, 2009

Baby Steps

This post may be a bit all over the place because I've been a bit out of it, so I apologize in advance. This week has definitely slowed me down a bit. Unfortunately, a virus tore through IU house sometime on Monday, and I found myself up all night throwing up. I was one of about fifteen people affected by the virus, and one of about five who were hit pretty hard. Tuesday, I didn't leave my bed and wasn't able to eat anything at all. Wednesday, I mustered up enough strength to shower and force down two pieces of toast, though it didn't go down without a fight. Today has been a lot better, and I'm hoping it will be my turning point. A group of us were scheduled to work at a farm this morning instead of at the hospital, so inspite of my illness, I decided to stick to the schedule and give that a go. The job was all manual labor, which might not have been the best idea seeing as how my only food intake for the last three days at that point had been 4 pieces of toast, but I thought that throwing myself back into things wouldn't be a bad approach. So I did, and I succeeded---though I will not deny that I was completely worn out after lunch. Speaking of lunch, I was able to eat some rice and fruit without problems, which was encouraging. Dinner was pretty similar. I'm still extremely weak and my energy level is low, but I'm getting there. Baby steps I tell you, baby steps...

Since I've missed the last three days of working in the hospital, the highlight of my week definitely has to be working at the farm. I worked with two local Kenyans--Carol and Joseph--who have both worked at the farm for 3-4 years. In a previous post, I made reference to the AMPATH program and how they feed ~30,000 patients infected with HIV to help nurture them back to health. The farm that I worked on today was an AMPATH farm that harvests crops responsible for feeding the patients. It was really interesting to work with Carol and Joseph, as we found ourselves lost in conversation while planting spinach out in the fields. They taught me a lot about Kenyan culture, giving me vivid descriptions of how tribal customs have shaped the atmosphere here. They also talked a lot about last year's political election and how corrupt it was. Hearing stories of the violence and clashes that went on during that time was enough to make me cringe, but I'm glad that Carol and Joseph were willing to share them with me. Working on the farm today was time well spent--not just because I was able to lend a hand to AMPATH, but because it was a great opportunity to learn from local Kenyans and get firsthand accounts of how they perceive their country. I'm really happy that I was able to bounce back from my illness for a few hours in order to take in this experience.

Well, tomorrow I hope to head back to the hospital to finish off the week. It will actually be my last day on the medicine wards, as I'll be switching over to the pediatrics side on Monday (yay!). As all of you know, pediatrics is where my heart truly lies, so I'm sure I will have many great stories for you once I make the switch. I hope everyone is doing well back home. Much love to all of you from Africa! God bless you always.

Monday, July 20, 2009

Conquering the Nile

This past weekend a group of medical students and pharmacy students traveled west into Uganda to go white water rafting down the Nile. It was an amazing trip. From what little I saw of it, Uganda seems like a very pretty country. The landscape is absolutely beautiful and local people we met while staying there were extremely good-natured. We traveled with 3 Kenyans that live/work here at the IU house and have been to Uganda many, many times, so they were able to show us around and introduce us to some of their friends that live there. It was a nice way to experience their culture in such a short stay.

As for the Nile River...what a sight to see!! Rafting was so much fun in so many ways. I had never been white water rafting before, so it was a great adventure. I learned that being thrown underwater by raging rapids can be fun as long as you have a life jacket to bring you back up in the end! Oh, and having a few crafty kayakers around to rescue you doesn't hurt either ;) When all was said and done, our raft flipped twice and multiple people were thrown from the boat while going through the rapids that didn't flip us. I managed to stay in the boat aside from getting flipped, and I think I was the only person who was able to do so. The rafting company put together a video of everyone's rafting experience at the end of the day, so I can't wait to show some highlights when I get back to the states.

Aside from the adventure, it was incredible to see the amount of Ugandans that were bathing and doing laundry along the banks of the river. It's a practice that is so common in places like Africa, and it's something that I love because it reminds me of how resourceful the people in third world countries are. Rafting down the Nile to a bunch of naked, cheering Ugandan children was definitely entertaining, and you have to admit, you'd never see that in the United States!

All in all, the trip to Uganda was a success. I'd definitely recommend white water rafting to the young at heart. It's a great thrill and makes for a fun weekend when surrounded by a good group of people. Now that it's over, I can proudly say that I conquered the Nile!

Thursday, July 16, 2009

Road Block?

So tonight I hit my first road block. I knew it would come at some point, and to be honest, I'm surprised I managed to avoid it thus far. I'll preface this post by saying that things in Kenya continue to go well. We are all safe and in good hands, so rest assured.

Here at the IU house, we have a series of lectures called "fireside chats". Once or twice a week, approximately 20-30 of us gather on the couches and floor space in the living area of one of the houses to discuss various issues. Some of the issues are controversial, some are historical, and some are informational. The 'chats' happen right after dinner and have a comfortable feel to them, as we are all cozied up next to the fireplace in a relatively small space. Tonight's chat featured Joe Mamlin, the founder of the IU-Kenya Partnership. I was really interested to hear his story and find out how he built this program. However, I had no idea how powerful his words would be or how intensely he would touch my heart with what he had to share.

Dr. Mamlin founded the IU-Kenya Partnership back in 1988. He built it from the ground up, with his main mission being to foster medical education in Kenya. His program started with one person and one vision. The first year of the program, he had 8 visitors that came through the IU house to participate in his mission. To give you an idea of how far he has come, we had 68 people at the IU house last week. This program is now a well-oiled machine that has accomplished so much. In essence, it helped create the Moi University Medical School here in Eldoret and has helped expand their teaching hospital to reach heights that no one ever envisioned. It no longer involves only IU, but has teamed up with groups from Duke, Portland, Brown, and the University of Toronto. And it just keeps growing and growing and growing.

In conjunction with the IU-Kenya Partnership, Dr. Mamlin started a program called AMPATH. Initially created to address the need for prevention and treatment of HIV in western Kenya, the program has shifted its mission and now stands for the Academic Model Providing Access to Healthcare. Just to give you some brief history, AMPATH began around the year 2000 as a group that treated 70 Kenyan patients for HIV free of cost. Currently, it provides HIV medication for 86,000 patients, all still free of cost. Because the program has grown at such a fast rate, Dr. Mamlin has changed his focus from HIV patients to all Kenyan people. AMPATH now has a component that feeds 30,000 starving Kenyans. He is adding new developments every day, including teams to foster mother-baby health care, tend to orphans and vulnerable children, and initiate income security programs by providing skills training to the Kenyan people. What Dr. Mamlin has done is truly amazing, and I can't even begin to tell you how lucky I feel to be a part of something this big.

So you all may be wondering what exactly is the road block I was referring to. Well, tonight was a huge emotional road block. For those of you who have spent extended periods of time abroad, you would probably agree that your time spent away from home is filled with a lot of emotional ups and downs. You have a lot of time to reflect upon your life and find out who you truly are. There has been a lot building up inside of me this week, and tonight was just the culmination of something that I knew was bound to happen.

Working at the hospital this week has been much tougher than the last. During my first week, I didn't really know my patients well, so I was more apt to turn my head the other way and let the little things slide. But the more you get to know your patients, the more you invest in them, and the harder it gets to let things go. It's been really tough trying to find ways to get things done at our hospital. Their system here is so broken. It takes so much effort to get even the smallest of tasks completed. At the end of the day, it really wears on you. You expend all your energy, but feel like you've accomplished nothing. To give you a little background, the ward I am working on at Moi Hospital has over a 20% mortality rate. Theoretically, that means that 1 in 5 patients that I see will end up dying. Though none of our patients have died yet, we have had several near deaths, and I know it is just a matter of time.

Though the hospital can be disheartening at times, Dr. Mamlin has reminded me why all of us are here at the IU house. The reason is simple: We care. I didn't come to Kenya with the thought that I would change the world in two months. But I did come to Kenya with hopes to gain ideas of how I can change the world sometime during my lifetime. There are so many people in this world that I want to help, both within the United States and globally. I'm just not sure how to go about doing it. Sometimes I think I dream too big. Other times I think I don't have what it takes to make things happen. So here I stand, in front of this road block. I keep telling myself to follow my heart, but it wants to go in so many different directions. Do I want to be a part of a lot of little things or just one huge thing, as Dr. Mamlin is? I don't have all the answers yet, but as long as this burning desire remains within me, I'll keep looking.

As most of you know, I come from a very religious family, and their influence has played a huge part in shaping who I am today. My Aunt Puppy has said to me repeatedly in life, "Go with God." In fact, before I left for Kenya, I got a voicemail message from her saying this exact phrase. I remember getting similar messages before leaving for Argentina and Honduras years ago. Though her words often escape me in life's daily routine, I find that I think about them constantly when I spend time abroad. They help keep me grounded and guide me in my travels. So as I lay here thinking, I will leave you with these last thoughts before I head off to bed: I may hit several road blocks along the way, but God is with me, and we are going together. Goodnight and God bless.

Tuesday, July 14, 2009

Safari Update

If I could sum up my safari in one word, I'd have to say INCREDIBLE!!! I can honestly say that it was the best trip I have ever taken in my life. I would highly recommend that everyone go at some point in your life if you get the chance.

Our trip began around 9am on Friday when a group of 17 of us left Eldoret and headed towards Masai Mara National Reserve, which is where our safari would take place. The drive was about 7-8 hours on sometimes paved/sometimes not so paved roads. I thought the drive itself was very interesting. The scenery was beautiful, and on top of that, we passed through a lot of small towns that gave me a much better feel for what the Kenyan culture was like. There were lots of people on the side of the road, some of whom were herding their goats or cows, others who were selling thier crops or simply just walking or lying down in the hot sun. We also drove by a few tea fields that were filled with workers harvesting the tea leaves. That was definitely a sight to see. I've never seen anything like it in back in the states.

We arrived at Masai Mara around 5pm, at which time we entered the park and went for a quick game drive (aka safari). The park is that is filled with tons of wildlife and spans a pretty large area, so our plan was to take a short game drive on Friday and Sunday and then drive all day Saturday in order to see as much as possible. Our lodge was a quaint little place called Fig Tree Camp, which was located inside the park. The rooms are actually "luxury tents", consisting of a large tent with three twin beds in it. The tent has a bathroom attached to the back with a full shower. When I say luxury tent, I mean luxury tent. It actually looks pretty comparable to a hotel room. The only difference is, it really is a tent. So, you have to un-zip the tent to get in and out, and you can hear the nature around you all night long b/c there are no walls to block it out. It was extremely nice, and I found it peaceful sleeping to the sounds of the outdoors all night. I actually think I want to live in one of these tents when I come home!

Our game drives were amazing. In just one weekend, we managed to see impalas, gazelles, zebras, hippos, vultures, lions, cheetahs, ostriches, hienas, elephants, wildebeasts, buffalos, giraffe and baboons. I'm sure I'm forgetting a few things too. On our last day, we actually saw a family of cheetahs hunt down a gazelle for breakfast. I'm not sure how I felt about seeing it, but it was definitely a good picture of nature at its best. All together, the safari was unreal. I can't even put into words how amazing it was to witness firsthand the natural beauty that exists in Masai Mara. Everything there is picturesque, and it will take your breath away over and over again. One of my favorite feelings in life is being amongst something so grand that it makes me feel exceptionally small. I got that feeling when standing at the top of Devil's Throat in Iguazu Falls when I was in Argentina; I get it when I go to mass in the Basilica at Notre Dame; and I definitely got it during the safari this past weekend. It truly was an experience I will never forget.

In addition to the safari, we managed to make our way into a Maasai village on Saturday evening. The Maasai people are a large African tribe that live in the region surrounding Masai Mara. Getting a tour of one of their villages was very interesting. They live in man-made huts, make their own clothes, and hunt their own food. As is true of many of the African tribes here, they also have their own language, tribal dances, and cultural traditions. We were able to see some of the dances and hear the meaning behind them, which was definitely a highlight of our visit. I have posted a few pictures from the Maasai village for you to see. They will give you a better idea of what the Maasai are really like. Naturally, I gravitated towards the children, so there a few pictures of some of the kids I saw there. At the end of our tour of the Maasai village, we got a chance to purchase some typical jewelry and souveniers that the Maasai people hand-make. And yes, Uncle Joey, I bought some of the necklaces that you wanted!!

Well, that's pretty much all about the safari. I could say a lot more, but to be honest, words just do not do it justice. As I stated in my very first blog entry, coming to Africa has been a life-long dream of mine, but before I left to come here, I found myself wondering why. I never really had any good reasons why I wanted to come here, I just did. I wasn't exactly sure what was drawing to this continent. Well, this weekend I got my answer. Africa is absolutely beautiful. Everything about it--the landscape, the wildlife, the culture, the poverty--is so pure. It speaks to you when you see it. It's very hard to explain, but I wish all of you were here to experience it with me.

It's about time for dinner, so I'm going to get going. I hope you enjoyed my brief recap of the safari. The pictures should help give you a better idea of what it was like. Have a great rest of the day and please take care. God bless you all.

Thursday, July 9, 2009

Getting Acquainted

Well, after spending a few days in the hospital, I'm slowly starting to get acquainted. It reminds me somewhat of my experience in Honduras--very dirty, very poor, and very few resources. Getting test results here can take what feels like centuries, that is, if the tests can even be performed at all. The CT scanner at our hospital has been down for months, and I don't think it will be fixed anytime soon. We also cannot order blood cultures and some other routine labs because they are out of reagents needed to perform the test. When ordering medications on the wards, your choices are very limited due to cost and availability. You always have to ask "what do we have in stock?" before making a decision on what to give your patients. Situations like this would never happen in the United States, and if they did, there would be an uproar. I wish all Americans could come here and experience what everyday life is like for a typical Kenyan. Perhaps they would have less complaints about their own lives if they did.

Today I spent the day at a clinic just outside of Eldoret in an area called Burnt Forest. It was a great experience. In general, the patients there were much healthier. When I say healthy, I mean it in a third world sense, not in an American sense. Every patient I saw today had AIDS, but in contrast to the patients we see in the hospital, most were doing quite well. Back home, we get caught up in the notion that 'everyone in Africa is dying from AIDS', when in reality there's a good portion of the population who are managing to fight off the disease. It was quite refreshing to actually see the part of the African population that is living with AIDS.

My time in the hospital thus far has been spent on the female medicine wards, so I have not been to the pediatrics ward yet. However, I got a little bonus today when I saw 3 kids at the Burnt Forest clinic. Their ages ranged from 2-6. All three were HIV positive. Every time I see a sick child, I'm reminded of why I am where I am today. There's something about a kid with HIV that tugs at your heart strings. As I continue to progress through my medical training, I feel like I am getting closer and closer to doing what I was put on this Earth to do. It's a great feeling---one that makes me excited to wake up with each new day.

I've posted a few pictures to help give you a better idea of where I am. One is of mine and Marissa's bedroom. You can see our bunk beds, which are covered by the mosquito net. I sleep on the top bunk. There are two other pictures of the IU house property....one of the dining room and one outside of the clothing line. The fourth picture is a picture I took on my walk to the hospital. It's pretty representative of what the streets look like as you make your way into the city of Eldoret.

That's all I'm going to post for now. This weekend, I'm going on a safari with a large group of people from the IU house. I should have lots of great stories when I get back. I'll be sure to post Sunday or Monday to tell you how it went. I hope everyone is doing well back home. Please let me know if there's anything else you'd like to hear more about in my posts. I love you all very much! Please take care. And as always, God bless.