Amanda’s African Adventure, Interrupted

Most of you know by this point that I am writing this from the comfy confines of my bedroom at 17 Bote. Two weeks ago, Sunday, my life took an unexpected turn. Kayla, Lauren, (two other American volunteers) and myself were walking to the Sunday market in Sori, the next town over from Karungu. It was a beautiful and busy afternoon, lots of people heading to and from the market on foot, motor bike, and car. We had headed out that day with the intention to purchase some goods for a family that was admitted to St. Camillus Mission Hospital due to an infestation of jiggers. This is actually a whole other fascinating story, which is described in detail in Kayla’s blog www.kaylainkenya@blogspot.com.

But getting back to me…I was walking along the side of the road and a man on a motorbike with a wood door attached to the back of it zoomed by me. The wood door made direct contact with my left arm….ouch! All I remember is seeing dust and the back of the man on the motorbike with that darn wood door. I remained upright but just kept repeating “I have to go back, I have to go back.” I tried my best to remain calm, I was in Kenya after all, Kenyans are the definition of stoic. After the quarter of a mile walk back to the hospital (thank God we didn’t make it further), I almost went down after slipping in mud outside the hospital gate…that’s when the tears came.

It was quite fortuitous that Lauren was with me because she is also an x-ray technician so she opened up the x-ray department for me (it is closed on Sundays), talk about VIP treatment. Unfortunately , the x-ray revealed a displaced mid-shaft radius fracture…no good! Viola, the Matron (nurse manager), and Zelpa, a nursing assistant, not only gathered the supplies to make a splint and brought me pain medicine but they also shared with me reassuring words and were a calming presence. Dr. Jimmy assisted with splint application, Kayla got ice, Lauren researched orthopedic surgeons in Nairobi, Christy gave moral support – it was truly a team effort by both the Kenyans and the Americans!

I just want to take this opportunity to thank, Kayla because she did a lot more than just get ice. She was a friend, nurse, and surrogate mom; she got up at 4AM to make sure I took Motrin, washed my hair in the sink, packed my stuff for the trip to Nairobi, gave moral support, and was all around awesome. So after calling my parents and Richard (director of the volunteer program) from CMMB, we made a plan to go to Nairobi for further treatment.

The next day, Father Emilio (Director of St. Camillus Mission Hospital) came through and got me an appointment with an orthopedic surgeon who was recommended by his “sophisticated Italian friend” as he put it. I was thinking – okay, sophisticated, sounds good and hoping that translates into - she has done her research. Everyone I saw that day told me, “pole (sorry in Swahili) or I am so sorry” which is the Kenyan way of saying , how are you? - so lovely.

We left for Nairobi early the next morning. Father Julius made the 8 hour journey with us, only stopping once to refuel. We arrived at MP Shah Hospital just in time to see Dr. Krishnan. Once he saw the x-ray, he gave me two options: 1. Plaster can be applied for 8 weeks and there is a chance the bone won’t heal properly or 2. Surgery can be preformed. Dr. Krishnan recommended surgery. Wow, I knew I wasn’t going to have surgery in Kenya but I was still hoping that maybe the break wasn’t that bad. So he ordered an x-ray that could be emailed so I could show it to a MD at home before I made decision to stay or return home. Dr. Krishnan placed a new splint on my arm and as he did it he said, “I am preparing you for travel."

After enjoying a yummy Indian lunch, we headed to get the x ray. During that time, I made phone calls home to my parents and Richard to tell them what the doctor had suggested. Before I knew it, I was going to be on a flight to London at 1130 that night. Although it was difficult to leave a place and people I had grown to care so much for, I also knew I needed full range of motion of my arm if I wanted to care for others in the future. After stopping by the St. Camillus Seminary for a few hours where Kayla repacked my back pack to make it light as possible we ate some dinner. We then headed for the airport. I gave “see you later” hugs to Kayla and Fr. Julius and started the second leg of my journey.

The flight to London and then New York weren’t too bad, I slept and watched movies. Even though, I was only there 6 weeks prior, Heathrow airport seemed bigger, brighter….so first world. It was such a relief to reach NYC and see the smiling faces of my mom and dad (who cut their Florida vacation short to meet me and take me to the hospital). THANK YOU!

We went straight to the good old NYP Weill Cornell emergency department. I didn’t escape NYP for very long but it was so nice and comforting to see familiar faces. I got more x rays, they gave me a Vicodin (which totally beats Motrin), and I got a room in the fancy area – totally VIP. I received excellent care from Teresa and Dr. Stern. The word spread that I was in the ED because I had lots of welcomed visitors. It was unexpected that I got to see everyone so soon but lovely just the same. I saw the Ortho residents who said the fracture was boarder line and maybe didn’t need surgery, they applied a new splint, and had me follow up with Dr. Lorich, the Orthopedic surgeon, on Monday.

My mom and I made the trip into the city early Monday morning. I got one more x ray (this was the 4th time) and then saw Dr. Lorich who explained the need for surgery – he was going to place 2 mental plates in my arm. So surgery it was…yikes, I was going to be a real patient. We spend the rest of the morning and afternoon doing pre-op testing.

That Wednesday morning my dad drove my mom and me into the city for the surgery. Overall the whole surgical inpatient experience went really well – amazing things really do happen at NYP! The nurses were really nice; thank you to Anne, Kathy, Helen, Marie, Ella, and everyone else. The IV insertion took a few attempts but that’s okay because I have really bad veins, I am my own worst nightmare. The anesthesiologists were awesome; I got a nerve block and conscious sedation – good stuff. The nurses in the PACU were great and then I stayed the night on Baker 15, the short stay surgical unit. I received IV antibiotics and pain medicine but there were a few hours during the night which were pretty rough, the pain was terrible. I only mention this because now I know what it is truly like to be a patient and it is a lesson learned that I will bring with me in the future, just like St. Camillus.

Thanksgiving this year means a lot more to me than eating turkey and watching the Macy’s Thanksgiving Day parade. I am so thankful to God to have access to excellent healthcare, to me born into an amazing family, have fabulous friends, have this whole new perspective, and have the opportunity to return to Kenya.

Wishing you a very HAPPY THANKSGIVING!!!

The Key to a Happy Marriage

After dinner several nights ago a conversation started over marriage. The conversation arouse due to an article in the Daily Nation, a Kenyan newspaper. The article reported that Fr. Muli (a Catholic Priest) “sparked a rare debate during Sunday Mass when he raised the sensitive issue of marriage between two Kenyan men in London recently.” The article goes on to say that the “Fr. Muli said men were resorting to marry one another probably because the women had failed to provide what they should in marriage….the priest challenged them (women) further that they had to be more Godly and ‘more womanly’ to attract men for marriage.” WOW! The absurdity of this article is multidimensional and misrepresents the teachings of the Catholic Church. Although it is not as shocking for me, as it is for those of you reading this, because these last few weeks have been filled with discoveries that life here is vastly different.

There are several different customs and practices among the many tribes in Kenya. Karungu is in Luo Land (the Luo tribe lives mostly along Lake Victoria). Polygamy is culturally acceptable. I met an 18 year old named Frank last week whose father has 6 wives and he was one of 50 children. If the husband and wife separate, the children usually remain with the husband’s family. If your husband dies you marry your husband’s brother or cousin not only because the dowry is paid for but also for survival. At the same time, if you are HIV negative and you marry your late husband’s brother you risk the chance of infecting yourself and the children you will have with him. The HIV rate is the highest in the Luo tribe compared to the rest of Kenya.

While the differences are many, Fr. Julius (a Kenyan priest in charge of St. Camillus Dala Kiye- an orphanage for children with HIV) reminded me during our after dinner conversation that some things are universal: the bond between a husband and a wife. He drew two over lapping circles on a piece of paper, labeled one man and one woman, and shaded in the center. He said, “you see, you need to pull toward the common bond. Both the husband and the wife need to compromise to increase the size of this (the shaded center part) which represents the strong bond of union.” He then went on to talk about the upbringing of children and the conjugal rights, and how it is the fruit of marriage and not just the consequence. I just kept nodding my head and thinking to myself, okay Fr. Julius, please stop here, which he did – thank goodness.

He also told me the importance of doing a needs assessment, that both the husband and the wife should express what they need to be happy. He gave the example that if a wife is tired and doesn’t feel like cooking that the couple agrees that they use the microwave to prepare the food, obviously, depending if there is electricity. Just to give a little back ground, cooking is a several hour and labor intensive process. I am not sure this particular example translates exactly but I think the meaning behind it does.

Hopefully, I will be able to put all this great insight to use one day. God willing (a commonly used phrase here).

Here are some final words of inspiration by Fr. Julius which I think can be applied in marriage and in life, “with growth comes involvement, with development comes inspiration, and with expansion comes motivation.”

The Theater

I have a new and exciting career in the Theater…which is actually the OR. Since there is no Emergency Department (or Causality as it is known) at St. Camillus Mission Hospital, I have been assigned to the Theater and the Out Patient Department (OPD). The whole hospital has 135 inpatient beds with a Peds ward, surgical ward, maternity ward, and a medical ward. There is an ART (antiretroviral treatment) clinic, a TB clinic, and a MCH (maternal child health) clinic. The OPD is where the patients are triaged by Clinical Officers which are like PA’s or NP’s as well as where wound care and small procedures are done. I have been learning about cockers, sutures, anatomical forceps, anesthesia – yes, the nurses are the anesthesiologists, and the list goes on. I am definitely going with the flow and taking it all in!

Sterility is definitely a relative term: there are ants and other critters crawling around the hospital. There is not strict counting of instruments or gauze during a surgical procedure - but they haven’t left anything in a person, yet. The nurses who do the anesthesia have no formal training (one has a lot of experience – thank goodness). There is one monitor in the hospital which is in theater – the patients are monitored during surgery but there are a limited number of EKG stickers so sometimes they just use the pulse ox and BP. Charting is sometimes optional.

The nurses clean the theater, something they call dump dusting. We scrub the instruments, pack them in a drape, put them in these metal drums, and then put them in the autoclave. We empty the trash and get the laundry. We fold gauze for the whole hospital. The gauze comes in these big rolls, sheets are cut; then we fold them in 3 different ways - ones for OPD, maternity, & theater. I will never look at a 2x2 the same way again - I am going to have Methloquine induced vivid dreams about folding gauze. I definitely have a whole new perspective – I thought life was tough as an ED nurse!

The first case where I scrubbed in was for a 9 year old boy with an appendicitis – my preceptor Becky told me I wasn’t bad for my first time. I was drenched in sweat by the end of it – the sterile gowns are cloth so they can be washed & refused (& put in the autoclave), you wear a big plastic apron under the gown so you don’t get blood on yourself and these white wellies (boots) that can be washed. It’s a sweat fest. But the surgery went well so that is all that matters.

In the OPD, I assist with wound and burn care, remove sutures, and give injections to inpatients and outpatients. It is somewhat similar to an urgent care center but mostly the wounds and burns are much worse. The patients tend to wait before coming to the hospital and use traditional herbs first and western medicine as a last resort. Just yesterday I observed several people at the entrance of the hospital trying to convince a man to get out of the backseat of a car and come inside the hospital to see the doctor. It’s quite a contrast to think of how people at home would call an ambulance for a sprained ankle.

Currently there are 6 babies in the Peds ward with severe burns. Most houses are one or two rooms so there are open flames where babies and children play. Their mother’s bring them to the dressing room in OPD and it’s heart breaking to witness because the babies are not always pre-medicated. I keep suggesting and asking about pain medicine but I am still the new mazungu on the block. I hope and pray that I will have more influence as time passes, and I think I will because everything happens pole pole (slowly in Swahili).

Here are a few interesting differences:
• A nurse is called a sister (I am not sure if a male nurse is called a brother – I don’t think so).
• The nurse manager is called the Matron.
• A unit is a ward.
• There are RTAs (road traffic accident) instead of MVCs (motor vehicle collision) which is more inclusive of donkeys, bicycles and other various modes of transportation.

I also want to wish my sister Alyssa a very happy 31st birthday! And a Happy Halloween to everyone!

First Impressions

I have arrived in Africa safe and sound! Sorry for the delay in posting…I am already getting accustomed to “African time” – just add an hour or a week in this case. The safari (journey) from Nairobi to Karungu was an amazing introduction to such a beautiful country and the realities of Kenyan life.


The two other CMMB volunteers (Kayla has a degree in public health and Jimmy just finished his residency in family practice) and I arrived in Kenya on the night of October 3rd. Boniface, the driver from St. Camillus, was there to meet us with a big smile. We spent the night at the Camillian Seminary. The next morning we went to mass at Our Lady Queen Church in the neighborhood of Karen which is named after Karen Blixen, the author of Out of Africa. Karen is an affluent part of the city with beautiful large homes. There was even a mazungu women (white person) out for a morning jog. The mass had beautiful singing and women danced in the aisle, it was a great way to start my first day in Kenya.

Then we set out on the open roads of Kenya which were paved for the first six hours and then became dirt for the remaining two hours. We passed through these little towns which were full of people, goats, cows, and chickens in the street. These “towns” consisted of a few rows of shops selling Coca Cola and cell phone minute cards. Several women had a baby strapped to their back and a bucket of water or a basin balancing on their head. Masai were herding cattle through the country side. A traffic jam consisted of waiting for a herd of cattle to pass while young boys with machetes moved them along. There was the most beautiful landscapes imaginable. We stopped at an overlook of the rift valley which was quite Lion King-esck .

We stopped in Narko for lunch to “take something” which means to eat something. My first taste of Kenyan cuisine was quite yummy, I had chicken and sukuma wiki (a green veggie like kale). Oh, and a light coke, yes, there is DC in Kenya – sweet! Yet most Kenyan homes to not have running water so it is easier to get a coke, if you have the money, versus clean water.

Our next stop was in a town called Kisii where we stopped at a big store, kind of like an African Kmart, where I got a cell phone. My phone number is 0714 795 305, just to let you know, in case you are in the area. But texting is actually prettying inexpensive so email me your cell phone numbers, please! So after our shopping experience it started to torrential down pour. Boniface told us it was very good of us to bring the rain – I thought it was the least we could do.

We arrived in Karungu just after the most beautiful sunset. We met Father Mario (the hospital administrator), some Italian volunteers, and the two American CMMB volunteers. It was quite exciting to meet Lauren, the women behind the blog - it is a must read (www.laurenmeisman.blogspot.com) as well as Christy who is also a nurse. Kayla and I settled into our house in staff quarters which is quite nice (I plan on posting pictures in the near future). I tucked myself in under my mosquito net and thanked God for one of the most amazing days I have spent on this earth.

A Fond Farewell

I said goodbye, actually, more like "see you later" to New York City this past July. I left New York with the knowledge that 1. once an ER nurse always an ER nurse, 2. you need to find your passion (especially when volunteering), and 3. to quote Frank "if you can make it here you can make it anywhere."
I have been fortunate enough to spend these last 2 months at home and prepare for the adventure ahead. I got all my vaccinations (9 shots in total - ouch!). My bags are packed (& locked) all 110 lbs of them - thanks to Laura & Mands for helping me weigh my behemoth bags on my bathroom scale.
I was accepted into the Catholic Medical Mission Board's Medical Volunteer Program and will be spending the next 8 months in Karungu Kenya (a small village on the southern banks of Lake Victoria). I am also happy to report I have surpassed my $5,000 fundraising goal and raised $7,150 to date towards my medical mission!
I will be putting my nursing skills to work at the St. Camillus Mission Hospital which was founded in 1997 by the religious order Servants of the Sick or Camillians. Part of the hospital's mission statement reads,

"At the St. Camillus Hospital, we are committed, day after day, to satisfy the needs of the sick, especially of the most indigent. Our mission is to show unconditional love to those who are suffering by offering them attention, solidarity and hope, in addition to appropriate medical treatment."
Wow - I can't wait to be a part of this!

But I couldn't go and care for the sick so many miles away if it wasn't for all the encouraging words, notes, hugs, and prayers from my family and friends. I had the most fabulous time at my bon voyage party yesterday. What a treat to have so many of the people I care about in one place!

I am going to NJ tomorrow for an orientation where I will be meeting my fellow volunteers and then off to Kenya this Friday, October 2nd. To be continued…..