We're in Africa!

Kenya to be specific!

Habari! (How are you?)

We have safely arrived, and as of yesterday, so has our luggage!  Yay!  You never miss clean socks, and other more delicates, so much until you only have the ones you are wearing!

We are staying at a "hostel" with an Austrailian medical student named Grace, who is from Malaysia!  We each have our own room, a kitchen that is well stocked with pots, pans and silverware, as well as our shopping from El Doret. We even have a bathroom and a shower, with hot water if we push the button an hour in advance of when we want to shower.

We are drinking hopefully clean water.  The system involves multiple 1.5 L bottles of water sitting in the sun for at least 8 hours, and then we put it through a large filtration system (maybe about 4-5 gallon size), and out comes slightly brown, but supposedly potable water!  We haven't gotten sick yet!  This is what the experts do, so we are hoping it works for us too.

We witnessed some frustrations from the first day!  Upon arriving on the ward we heard of a baby with an oxygen saturation of 25%!  (Never seen anything that low in the US!!).  Even when we brought the baby to the warmer, the saturation was still only 30%.  We had to bag the baby for a few minutes, and then with an improved heart rate, warmth, and oxygen the sats improved.  The baby was born at home at about 7 months.  28 weeks.  No steroids.  No US NICU.  We started the baby on IV fluids, and IV antibiotics as well as aminophyline (instead of caffeine).  The baby is now three days old and doing well.  We will start expressed breast milk via naso-gastric tube feeds tomorrow.  It is amazing how well such premies can do!  The most frustrating part of the admission is that the CO - kinda like a sub-US standard mid-level provider, had already written the entire admission note before addressing the o2 sat of 25% and reporting to the doctor!

The second frustration came when we were just finishing up the baby's admission, and then we were notified that his mother was having a post-partum hemorrhage.  Another medical emergency, and nothing was said about it until how much time had passed?  We looked all over the maternity ward, walked up to the outpatient department, checked the female medical ward, and then came back to maternity and confronted the nurses. After considerable literal running around, we finally found the patient.  Her bleeding thankfully had slowed but she was quite weak and had very pale conjunctiva.  Without waiting for the results of her hemoglobin, but noting her hypotension and tahcycardia, we started her on 2 units of blood (which she pressed against her own body to warm up to body temperature!) and 2 L bolus of normal saline.  After the first unit, she began to feel much better, but even on the day after delivery she was too weak to get out of bed, and orthostatic.  On the second day, however, she was sitting up on her bed, ambulating well, and feeling much better.  She was technically dismissed today, but will be around for quite some time as she will be expressing breast milk to feed her baby by NG tube every two hours until he weighs 1.75 kg, at which time we'll switch over to partial cup/partial NG tube feeds, and then allow straight breastfeeding.  He was born at 1.2 kg, and currently weights only 1.12 kg, so he has a way to go!

***And now, a word from Katy ******

Kapsowar is not quite what I expected of the dry, hot Africa. Being up in the highlands, it's actually quite lush and has beautiful weather. The dirt roads are of red soil, which is a beautiful contrast to the green tree and grass, all against the backdrop of the slopes of nearby hills, marked out by blocks of fields and dotted with houses. The people are very warm and kept welcoming us even days after our arrival. They are a quite reserved culture and don't show much negative emotion. The children are very shy, yet eager at the same time, to say a quick, "How are you?"(And then giggle away if we try to initiate more conversation in English)

Our first Sunday worship at the African Inland Church next door was an outdoor service, which meant a special event and longer time involved. It was a special gathering to bless the students who will be sitting for their primary and secondary school exams. The service began with four different choirs, each came out humming a hymn a capella. Did I mention it was a longer service? What I thought was especially fitting and nice was that after the sermon, one lady came up to address the students and gave an encouraging speech about "Do Not Fear", quoting several Scripture verses about how God has a plan to prosper us and not harm (or fail) us, and we do not need to fear when we trust in God because He will provide. She said the exams are necessary in order to get to the good future that God intends for them. I thought that was a very appropriate message for us, too, as we began this new experience.

So far, we've had several African cuisines, and by that I mean meals we cooked in Africa, with the help of canned chicken, Knorr soup mix, pasta, and take-out. Okay, the first day, since we didn't know how to work the gas stove, we had cheese, crackers, carrots, and apple slices for lunch and dinner--yes, we were adherent to a healthy diet. After that, we finally got matches and were able to make some pasta, "beef mince" hamburger (that was medium rare, unintentionally), and one time had Chinese take-out from Eldoret. The Szechuan beef and sesame chicken in Africa are not quite the same as their American Chinese counterparts.

Tonight we experienced our first blackout, so we had to make our soup, baked beans, and mashed potatoes in the dark, with the help of flashlight headlamps (Thanks, Marta's Mom!!) We also got to enjoy lighting by kerosene lamps :) Thankfully, electricity came back after a few hours, so we can give you an update on our whereabouts.

Being a good Asian I've taken many pictures, but due to the fact we're using someone else's portable internet modem that's charged by data transfer, we need to figure out how to upload images in the smallest file size possible. So, please be patient with us. Thank you for reading, if you are still reading..... :)

Love,
Katy and Marta