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The roller coaster of life

March 11, 2011

Another busy day (Friday) is in the books. We had to start the day with a PR photo shoot at the IU house since we haven’t posted a picture of the three of us (Go Colts!). The majority of the day was busy with presentations and unscheduled meetings. Most of these meetings are unscheduled but are in reality very important to determining the feasibility of having an open heart surgery program here.

I’ve always found that a lot of work can be done through by being available and attentive to what is going on. One perfect example of this occurred when we were touring the AMPATH building. The AMPATH building is one of the main sites at the hospital for the HIV clinics, research and laboratory services. This is also the site where Ginnie helps out with the weekly pediatric cardiology clinic. The NIH NHLBI team was actually touring the facility as well. This is the institution that provides significant grant funding to Duke to develop the Center of Excellence in cardiovascular medicine. It was a great unscheduled opportunity for Ginnie & I to introduce ourselves to the director and deputy director from the NIH section as well as the Kenyan partners at Moi. Who knows where it will go, but it’s good to meet some players that are involved with moving cardiovascular services forward.

NIH NHLBI Team

We stopped briefly into the OR (or Theatre as it called in this British fashioned medical system). My “firm” or team is on call this week and our major OR day is Friday. There were a wide variety of cases in progress. The neurosurgeon was resecting a massive brain tumor. General surgery was conducting a bunch of cases from groin hernias, anal fissures to wound debridement of diabetic foot ulcers. Of course orthopedics leads the way operating five days a week. This may seem strange to many in the US, but the reality is trauma in the developing world is a big problem. Many are due to motorcycle taxi injuries, vehicles hitting pedestrians etc. It’s incredible the number of accidents that happen. I remember admitting three to five new patients for ortho bone or hand work everyday we were on call that last time we were in Kenya. While I was in the OR, I also meet the medical officers on the surgery service. They must have just turned over because I don’t remember them from our major ward rounds yesterday. I look forward to working with them more closely next week. I still haven’t figured out the system entirely yet, but I think there is an in-house intern that sees emergent patients at night. Then if there is a problem the medical officer comes in to see them and if necessary takes them to the OR sometimes without the attending (or even maybe often depending on the skill level of the medical officer). So I’ll be with this team and hopefully work with the CT surgeons whom I have not met yet as well.

Nonetheless despite the busy pace of these meetings and trying to figure out the schedule, there is still sometime to slow down and enjoy the weather and the wildlife unique to this area. We ate lunch at a local “milk bar” called the Oasis (the rough equivalent of an ice cream and hamburger restaurant in the US). Ginnie took this picture of this very colorful bird that was perched on a tree next to us. We had a nice meal of “chicken and chips” that Matthews enjoys. You can imagine that with meal of chips (fries) and multiple non-diet sodas (they do have Diet Coke but it’s not easy to come by), you can gain a ton of weight here. My goal is to avoid that and hopefully starting running again in the mornings here when it’s cool out. The altitude adjustment may be a little challenging for me, but I have another 4 or so weeks to build up.

The goat roast

After lunch, Ginnie gave another great talk today to the pediatric medical officers. At the end of her talk, she asked the MOs some questions about culture. One in particular was about the topic of discussing with parents the impending death of a child for example from a congenital heart lesion. The discussion of death is a difficult topic for the MOs. In fact, they admitted to trying to avoid the conversation at times. The other questions she asked was about what they would like to change in their program. In the US, this would usually result in complaints about ancillary medical services, call hours, faculty members etc. I know these MOs have the same issues, but they focused primarily on the inadequate resources that prevented them from providing care to the patients. The resources revolve primarily around two things–the patient’s lack of money to pay for treatment or a simple lack of medical supplies. The former is illustrated by the cost of hemodialysis. Moi actually has numerous people with kidney disease on hemodialysis to clear toxins that there kidney no longer can. Unfortunately, the cost of this treatment is ~10,000 KSH (divide by 80 for USD). This is an extraordinary amount of money for a Kenyan where 100 KSH (~$1.25) can be considered a good daily wage. Despite all these challenges, the MOs are nonetheless extraordinarily hopeful. They want to help their patients as best they can. They want to build a better system. These MOs are clearly some of the best and brightest in Kenyan medicine.

The evening closed with reuniting with a colleague from the surgical ICU, Charity whom I mentioned in a previous post. She is pictured 3rd from the right in the picture above. This is a large contingent of the IU staff/residents at a local restaurant where we had roasted chicken and goat (actually quite tasty but a little chewy if not cooked correctly).

Finally, we did get up early this morning (4am now Saturday) to Skype back to the kids. It sounded like our son had a rough time the past few days. It’s certainly hard for them to be without their mom especially when they are this young. Initially, Noah didn’t want to talk to us by phone, but he enjoyed the video call and seeing our room here in Kenya. Esther however completely lost it not being able to get a hug from mommie over the internet. Fortunately, Ginnie will be heading back soon to be with them. Certainly would appreciate continued prayers from them, us and Caleb and Melissa.

An update on my friend Micah–he is actually doing tremendously better! He may be freed from the ventilator in the next few days. That is huge progress for which we are eternally thankful. I’ll keep everyone posted on how he is doing.

We are heading off to Tenwek (link in the lower right of the blog—if you’ve never seen it), in two hours. Internet connectivity is slow there, so I may not post until we get back Sunday evening at the IU house. We are going to visit some dear friends who are there (McCropder link also in the lower right).

Again we are always grateful for your love and prayer support. We appreciate your encouraging emails and comments.

God bless…A&G

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One Comment leave one →
  1. March 12, 2011 6:17 pm

    It looks like the weather is very nice there its a little better here also. I’m sad to hear about the kids having a hard time hopefully it was short lived like when you leave them at the babysitters.
    Seems like you are getting a lot of things done in ashort time.
    Aaron I have enjoyed your pictures and Ginnie’s as well the bird was beautiful.
    I’m glad you didn’t go to Japan with the earthquake.tsunamie and now nuclear power plant meltdown.
    Bye for now
    Mom

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