My training in Kenya, part 2

I am writing this post in the front seat of a van during a 5 hour drive from Eldoret to Lake Naivasha.  This is the first chance I've had in a while to take a moment to collect my thoughts. Some of these thoughts are difficult to write out, to be honest. 

I lost a 3-month old girl last week. She came in on Thursday with respiratory distress and failure to thrive.  With the help of a Kenyan medical student to translate Swahili, I learned everything about this child.  The village she came from, the history of her birth, every detail about her diet, her developmental milestones.  Then I examined the infant's entire body, including each finger and toe.  She was gasping for air, despite a heavy flow of oxygen through the nasal canula.  I listened to her heart, which was beating furiously. Instead of the usual "lub dub" of the S1 and S2 heart sounds, all I could hear was a constant "shhh", indicating she had heart defects.  The next day during rounds I presented her to the team during rounds.  We discussed and gave her all the supportive care available along with antibiotics.  When I came back on Monday, her bed was empty.  I assumed she must have been discharged, or perhaps was taken to radiology.  I asked the intern. "She didn't make it".  That thought had not even crossed my mind. Children aren't supposed to die.  I really should have learned by now, especially after losing incredibly brave children I helped take care of on the heme/onc floor at Riley back home. I don't think you can ever get over the shock though. I can still hear her heartbeat, and I can still picture her tiny little hands. 

Now I am taking care of a 3-month old boy, also with difficulty breathing.  He has already been in the hospital for a month due to numerous delays in diagnostic testing.  When I expressed my frustration to the intern on my team he said, "This is Africa", a phrase that frankly makes me angry when I hear it. It means there's nothing else to be done. Fortunately there are a team of otolaryngologists here with AMPATH, and once I told them about the infant they did not hesitate to help evaluate and care for my patient.  Seeing physicians from different backgrounds working together towards a common goal is incredibly inspiring. 

On Friday the 12th, I went to the Tumaini Innovation Center with medical students and team members from pharmacy at Purdue.  This is a safe-haven for street youth, and has a mission of giving children and adolescents marketable skills in sustainable farming.  I have been familiar with Tumaini as it is one of the organizations supported by the Annual IU Hunger Banquet hosted by the Global Health Student Interest Group.  I try to take my guitar with me whenever I travel, but never have I found my guitar to be such a source of joy.  Instantly a crowd of children gathered around, and two of the older boys, Nyagah and Joseph, ran and grabbed two guitars donated previously to the center.  The guitars were dusty, old, and missing strings.  Exactly like the first guitar I ever played 17 years ago at summer camp.  I saw in them the same excitement I experienced that day.  I first taught some percussive technique, showing how to hit the guitar in different locations with your fingers and palms to create unique sounds.  Nyagah and Joseph were naturals.  I showed them some basic chords and strumming techniques and soon we were jamming like bandmates.  Maria observantly called us "Guys in Red" (we were all wearing red shirts).  Hard to believe that a couple weeks ago I was raising money for these kids on stage with my guitar in Indianapolis.  Full circle. Before I left I played football with the local children as the sun set.  They were much better than me, even the ones playing with flip flops or barefoot. 

On Saturday we went to Umbrella Falls, 30 minutes away. This waterfall is fed by the Sosiani River, and powers a hydroelectric generator which provides power for half the city of Eldoret.  I recommend this trip to anyone who has an opportunity to visit; you can climb behind the waterfall and the view is spectacular.  On Valentine's Day, we hosted Kenyan medical students at IU House and played a few competitive rounds of "Blood Croquet" (miniature golf with croquet mallets). It was great to spend time together outside the hospital. 

Have you ever made a list of the best moments in your life? I haven't, but somehow I know Wednesday morning would make that list.  I drove with Sarah Ellen Mamlin to three different shelters for orphans, guitar strapped to my shoulders.  First we went to the Amani (Peace) Center.  This center supports children of mothers inflicted or deceased from AIDS.  These children were an absolute joy.  I played some of my original music, played Mombasa by Tommy Emmanuel, sang Jambo Bwana, and we goofed and danced to some of my favorite songs from my songleading days at summer camp.  Titles included "Shake My Sillies Out" and "Peace Like A River". These children are supported through the AMPATH Orphans and Vulnerable Children Program (OVC), which also benefits from Hunger Banquet, which is March 5th. I hope to see you there!
http://www.iusmhungerbanquet.com/
http://www.ampathkenya.org/our-programs/social-health/amani-women's-shelter/  

Next we visited Neema School, where half of the students are orphans. They caught on to the songs incredibly quickly and sang and danced without any inhibition.  It was quite remarkable. Before I left, they sang me a song they had learned. It was about being thankful for what you have in life, and their voices were beautiful.  I was holding back tears.

https://www.facebook.com/Neema-childrens-home-Eldoret-186224768171657/  

Finally, we visited the Leister family home (Also called Tumaini Center).  This family from the United States moved to Eldoret in 2007 and has fostered over 100 children, many of whom received care through the Sally Test Center Moi University.  They are a remarkable family, and we had a fun time singing together.

http://familykeysint.com/horace-and-phyllis-leister/  

On Thursday I visited the Imani (Faith) Worskshop. This workshop creates beautiful artisan crafts ranging from textiles to jewelry to paperwork, and the employees all have HIV.  It is an incredible testament to the strength of these women that they come together to bring such beauty into the world.

http://www.ampathkenya.org/our-programs/family-preservation-initiative/imani-workshop/  

The people here experience so much tragedy in their lives, but they persevere.  Children, men, and women show so much determination when each day brings constant challenges.  I have thought a lot about what this means to me.  I think in our lives we often spend much of our days trying to survive to the next day. Work, finances, health. I know I'm guilty of feeling like I'm hanging by a thread, barely surviving.  Now I have a new perception. Don't survive, thrive.  Find a way, no matter how hard it is, to thrive where you are.  That's what I see here.  From the children and parents in the hospital to the orphans and working men and women in the cities and fields.  They thrive in the face of death.  This is Africa.

 Playing music with children at the Tumaini Innovation Center. I hold the chords, and they strum.

Football at Tumaini Innovation Center.

Music at the Amani Center.

Sarah Ellen Mamlin spends time with children at Neema School.