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 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 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.

Sunday, July 5, 2009

Safe 'n Sound

Jambo from Kenya! Well, after a long journey, our group is now in Eldoret and beginning to get settled. Every aspect of our trip went smoothly--the bus ride from Indy to downtown Chicago, the subway from downtown to O'hare, the flight from O'hare to Amsterdam, the flight from Amsterdam to Nairobi, the overnight stay in Nairobi, and the final flight from Nairobi to Eldoret the next morning. My friend Ryan and I (who both rode the bus from Indy to Chicago) commented several times that we felt like we were in the movie Planes, Trains, and Automobiles!

We arrived in Eldoret on the morning of July 4th. When we got to the IU house, we were informed that there was going to be a 4th of July celebration amongst the Americans at 3pm. Everyone was preparing a dish to contribute to the festivities. After getting a brief tour of the grounds and being shown to our room, the four of us headed into town to run a few errands and figure out what we could bring to the BBQ. We decided on deviled eggs, which were actually quite a hit! The 4th of July party was a lot of fun and a great opportunity to meet people on our first night here.

As of right now, we are staying at the IU house. I am rooming with Marissa--the other female 4th year student who came in our group. The two males in our group--Ryan and John--are also sharing a room. The boys will probably be moving to the hostel very soon. Marissa and I will move over to the hostel when a room becomes available. That may not be for a few weeks, but we aren't sure. The IU house is very nice. It's actually 5 houses within the same property, which means there are a lot of people coming in and out. One of the houses has a big kitchen with a dining area, which tends to be a big gathering place. Wireless internet is pretty reliable here, and I am able to logon with my laptop at my convenience. Once I move to the hostel, internet will become less reliable, but I will be able to come to the IU house to use the internet here.

This morning, I went to mass in town with two Canadian medical students who are staying at the IU house (only one of which who is catholic). I have not come across too many catholics at the IU house as of yet, but I'm glad that there was at least one to take me to mass on my first Sunday here. I always get mixed emotions when going to mass in foreign countries. It's a very different feeling to be the only 3 "white" people in a church (and I'm not nearly as white as the blond Canadian that was sitting next to me). There was a little girl sitting in front of us who stared at us the entire mass--she was very intrigued. At one point she actually came into our pew and climbed over everyone to get to us. We smiled and waved at her. She was as cute as can be. Mass had a lot of similarities to that in the U.S., but it definitely had its differences. They sing and clap here more than we do back home. All of the song is in Swahili (with bongo drums and everything!), giving the mass a more cultural feel. There are no collection baskets, but rather a wooden box with a money slot on top that sits in the front of the church. Thus, at collection time, everyone stands up and walks single file in organized fashion up to the front to give their donation (much like we do at communion time). Communion, on the other hand, is a free-for-all. It's very similar to my experience in Honduras. Everyone gets up and goes up to the front whenever they want to, rather than going row by row. It was interesting to see how the African culture plays a role in the catholic mass, mainly through their expression of song. However, the most intriguing thing about mass to me was the fact that the bulk of it was exactly the same as home. Here I am, half way around the world, and I could literally speak the Eucharistic prayer along with the priest because it was so familiar to me. There were no language barriers or cultural differences at those parts of the mass. That was a first for me, because ever other country I have visited has been Spanish speaking. It was a very surreal moment and was evidence to me that we all really can be united despite all the differences that exist between us.

Anyway, I'm going to get going. A group of us is about to go for a run. Eldoret has an elevation of about 3000 ft, so we'll see how well it goes! I hope enjoyed their 4th of July! I'm starting at the hospital tomorrow, so I will write again soon to let you know how it is. In the meantime, take care. Much love to everyone from Eldoret. God bless.