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The Memories

05/09/2009
by
The Safari Crew (Cindy, Sarah, Aaron, Ginnie, David, Jananne and me)

The Safari Crew (Cindy, Sarah, Aaron, Ginnie, David, Jananne and me)

As I approach my last week here at Tenwek Hospital, I can’t help but reflect on my time here — the successes, challenges, blessings, miracles, deaths, lives saved, sleepless nights, friendships, and learning experiences. As I type this email, I feel as though the energy I arrived with on July 7th has been overshadowed by emotional and physical fatigue. The long on-call days and nights and unparalleled magnitude of witnessed deaths have taken their toll. Yet the sense of fulfillment that I’m leaving with cannot be compared to any other work experience I’ve had. It’s an amazing feeling to know that my daily work, prayers, and time are making a difference in people’s lives and to be able to see the fruits of my labor.

I was recently asked what the most memorable part of my experience has been. It didn’t take much thought to say, “the people.” The patients, long term missionaries, staff, and visiting medical students and physicians from across the world have my time priceless and have been permanently etched into my heart.

The people and staff native to this area welcomed me with open arms into their county and their homes. They shared their life stories, taught me some of the language, and treated me as family. I shared many laughs with interns on the wards, particularly Ronald, Hillary, Zahura, and Evans. The moments before rounds when I would drink chai and eat Mendazi’s (fried dough similar to donuts) with them or with the endoscopy suite staff (Reuben, David, Benard, and Robert) were invaluable. It was at those times that I learned the most about Kenyan culture.

Almost equally memorable are the meals and bible study time spent in fellowship with the long term missionary staff. These people have sacrificed some of the comforts of practicing medicine and surgery in the states, to devote their lives and those of their family to spreading the gospel and ministering to the people of Kenya through medicine. They have fostered an environment of faith and holiness here at Tenwek.

The most memorable people; however, have been those with whom I’ve spent the majority of my free time — namely, the guesthouse visiting staff and students, Patti Wamuyu, and Stephen Leimgruber.

Frank's birthday party in the guesthouse kitchen

Frank's birthday party in the guesthouse kitchen

The guesthouse is filled with people from all walks of life in the states and abroad, but who all have a common mission in being here. We have easily become friends and will likely remain so for a long time to come. Aaron, a surgery resident and future cardiothoracic surgeon who created this blog, and I bonded early during his stay here given our similar sense of humor. When he and his wife left, the guesthouse was never the same. Dave and Naomi were selfless in sharing their snacks and movies with me. Frank, a German medical student, and I got into an hour long discussion about relationships on his first day here. We became acquainted through our similar experiences of long distance relationships which would often be the topic of our conversations. Melissa and Jeff, newlywed medical students at VCU, were quite entertaining and gave me a new perspective on marriage. John, a medical student from Alabama, and I had many intense racquetball games and often exchanged jokes, particularly about the German’s obsession with David Hasselhoff, as we learned from an “E! True Hollywood Story.” The German medical students adamantly denied this though.

Patti, me and Mike

Patti, me and Mike

Nonetheless, my closest friends have been Patti and Stephen, two of the most generous, humorous, spiritual, and cool people I know. On any given evening, Stephen and I could be found at Patti’s house, eating her food, watching her TV, or both. We talked about any and everything. Nothing was off limits. They have been like my brother and sister and I will miss them dearly.

But brother is not the only name and role that I have adopted since being here. I have been called “doctarie” by the natives (as Swahili for doctor), “that cool doctor” by some of the interns, and a “prayer warrior” by one of the visiting staff.

Overall, this has been an unreal and blessed experience, and hopefully the first of many mission trips. Nonetheless, I’m ready to come home. I can’t wait to see family, friends, and undoubtedly Brittney. Communication via Skype has been fun, but I can’t wait to share my experiences and joy in person. Thank you all for your prayers and support. May God bless you.

Peace and blessings,

Darrell

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When Everything Goes Wrong

24/08/2009
by

This morning was a disaster! As I sit at my desk, after taking a hot shower and eating lunch trying to decompress, I wish that I could start the day over. On rounds this morning, when trying to do my best for one patient, everything went wrong at the wrong time.

He was a 35 year old Kenyan who was admitted last night secondary to heart failure. Though he was having mild respiratory difficulty last night, he was not in critical condition by far. This morning on rounds, I found him in respiratory distress, working hard to breathe and unable to talk because all of his energy was being used to breathe. No pulse oximeter (machine used to measure oxygen saturation) was anywhere close. I firmly asked the intern to start the patient on face mask oxygen immediately while I went to look for a pulse oximeter. I walked briskly to the female medical ward . . . .no pulse oximeter. I walked even faster to the pediatric ward . . . they had a pulse oximeter but no probe (vital for the measurement). I jogged to the ICU and they had what I need. Upon arriving back the bedside and examining the patient again, his breathing became more labored and his heart was beating at a lethal speed, 180 beats per minute. I asked the intern and closest nurse where the EKG machine was . . . no one knew. I ran to the ICU only to be told that the two EKG machines in the hospital were not functioning properly. So I ran back to the male medical ward, rummaging around for a defibrillator machine . . .my only hope for visualizing a heart rhythm was using the paddles on the defibrillator. I found one and hurried to the patient’s bedside . . . no power. I attempted to plug it in . . . no adapter for the electrical socket. Three minutes later an adapter is found and I aggressively placed the paddles on his chest . . .his heart was still beat 170-180 beats per minute and the rhythm looked like supraventricular tachycardia (SVT). I knew exactly what I needed . . . .Adenosine IV. There was no Adenosine in the code cart. I ran to the pharmacy . . .no Adenosine. I ran to the operating rooms . . .no Adenosine. I found some Propranolol, a poor substitute especially given that the patient was in acute heart failure as well. I get back to the patient, his bedside was crowded with interns and nurses who were attempting to help, and his heart stopped just as we were attempting to administer the medication. As on of the interns was bagging him (giving oxygen manually via a mask) and a nurse was giving emergency IV medications per my order, I performed chest compressions for 15 minutes (which felt like eternity. All the while I knew that there was no available ventilator and no room in the Intensive Care Unit) . . . .no heart rhythm, his pupils were fixed and dilated, he was dead. I was in such disbelief . . .everything had gone wrong. Sure, I have seen plenty of people die, but I knew that he should not have died like this. I took it hard. I had the leave the ward and outside for some fresh air. I sat in the outdoor chapel and prayed. When I gathered my composure, I returned to the ward, prayed over the patient, and then counseled and prayed for the family. Finally, I let it go and resumed rounds.
 
I found strength in 2 Corinthians 4:7-11, 16-18. “But we have this treasure in jars of clay to show that this all-surpassing power is from God and not from us. We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted, but not abandoned; struck down, but not destroyed. We always carry around in our body the death of Jesus, so that the life of Jesus may also be revealed in our body. For we who are alive are always being given over to death for Jesus sake, so that his life may be revealed in our mortal body. vs 16 Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day. For our light and momentary troubles are achieving for us an eternal glory that far outweighs them all. So we fix our eyes  not on what is seen, but on what is unseen. For what is seen is temporary, but is unseen is eternal.”
 
Im headed back to work. Just had to get that off my chest and mind.
 
Peace and blessings,
 
Darrell

How did that happen?!

23/08/2009
by

Have you ever looked at something or someone and just thought to yourself, “How in the world did that happen?!” Well, I had that thought innumerable times this week as I continued my mission in doing God’s work in caring for the sick at Tenwek Hospital.

The ICU

The most memorable patients were two young ladies in the Intensive Care Unit, both of whom are now in glory. The first young woman had rabies, apparently contracted after being bitten by a rabid dog. This is a condition that carries a 100% mortality. Despite our aggressive care, she would eventually succumb to her illness. She had high fevers and excessive drooling until her time of death.

The second young lady had severe tetanus. She sustained an injury to her Achilles tendon but didn’t report to the hospital until the wound was gangrenous and he was experiencing diffuse spasms. Despite receiving appropriate antibiotics, sedatives, and paralytics, she continued to experience high fevers, respiratory distress, and frightening appearing spasms until the time of her death.

The Female Medical Ward

Performing a skin biopsy.

Performing a skin biopsy.

In my brief time in the field of medicine, I have seen things that nightmares are made of and have seemingly mastered the art of the “straight face” — never letting my internal reactions to putrid odors or skin crawling sights show on my face. However, when I saw this lady’s skin, I know she had to see “What in the world?!” written all over my face. **I will interrupt this message to give you a public service announcement — If you notice a rash that is seemingly eating away at your skin, DON’T WAIT UNTIL IT HAS SPREAD ALL OVER YOUR BODY!** Sorry, that was an aside. Now normally after a physician fully evaluates a patient, he or she makes a mental list of several possible diagnoses before initiating treatment.For this patient, I had a mental list of about 15 potential diagnoses. The good news was that though her skin looked horrific, she was not very ill. This was obviously a slow developing skin condition that she was not a risk of dying from on my watch. I knew that no matter what I prescribed her, it would not go away over night. Nonetheless, I gave her some medicine, took biopsies of her skin, made sure she was comfortable, and sent her home with the plan to return in 2 weeks when the biopsy results would be available and I could tailor her therapy.

Another dermatological rarity--cutaneous anthrax.

Another dermatological rarity--cutaneous anthrax.

Casualty (The Emergency Room)

The following event occurred about 2 weeks ago. Have you ever been busy, totally immersed in something, only to be overcome with a feeling that someone is watching you? Well, one particular evening, I was in Casualty talking with my intern about a patient we had just seen when I felt as though someone was staring at me. I turned around and saw an expressionless young male standing behind me. I looked him over only to discover he was dripping blood on the floor from his right hand. On closer inspection, he was missing three fingers.

Penetrating trauma--arrow in the left flank.

Penetrating trauma--arrow in the left flank.

Three fingers! And it seemed as if he was not in any pain. Apparently, he was riding a motorbike, tried to avoid some donkeys in the road, and crashed. Motorbike injuries are extremely common here and usually result in a lot more severe injuries than his. Other peculiar things that I have seen in Casualty include drunk men recently trampled by elephants, men shot with arrows over cattle, and women and men struck repeatedly by pangas (machetes). Again, all I could think was “How in the world did that happen?!”

On a more positive note, I received a scripture last Sunday that I marinated on all week and would like to leave with you. It is from Matthew 25:14-30. It is a very familiar passage of scripture known as the parable of the talents. Its a story of man who was going on a journey and entrusted property to his 3 servants. “To one he gave five talents of money, to another two talents, and to another one talent, each according to his ability . . . The man who had received the five talents went at once and put his money to work and gained five more. So also, the one with two talents gained two more. But the man who had received the one talent went off, dug a hole in the ground and hid his master’s money.” The story does go on to say that when the man returned from his journey, he was able to say “Well done good and faithful servant” to the two servants who had multiplied their money. To the other servant who had hid his money, the man said, “You wicked lazy servant!” As is written in the red letters of the Bible, Jesus says, ” For everyone who has will be given more, and he will have an abundance. Whoever does not have, even what he has will be taken from him.” So I pose the question, what will you do with the talents that God has blessed you with?

Thank you for your continued prayers and encouragement. I miss you all dearly and will return to the states in approximately 3 weeks.

Peace and blessings,

Darrell

What’s That Smell??

13/08/2009
by

“Therefore I tell you, do not worry about your life, what you will eat or drink; or about your body, what you will wear . . . Who of you by worrying can add a single hour to his life? . . .Therefore do not worry about tomorrow, for tomorrow will worry about itself. ” Matthew 6:25, 27, 34.

“For we are to God the aroma of Christ among those who are being saved and those who are perishing.” 2 Corinthians 2:15

What a grand calling we have — to be “the aroma of Christ.” Despite the varying stressors of the work week, I have attempted to focus on being that aroma, such that the fragrance will overpower the stench of my worries,and those of whom I encounter on a daily basis.

The end of last week was especially challenging. Rounds one morning, a morning that will forever be etched into my memory, started with two female patients on either side of the room having seizures almost in tandem. One of the ladies was bleeding profusely through her urinary catheter and the other lady was so frail that her momentary violent seizure looked as if it would break her in two.

On the Female Ward

On the Female Ward

After resolving those issues, it was only minutes before I encountered another perplexing situation. I was called to another room in which I found a patient seemingly comatose. Though her vital signs were stable, her pupils were dilated and non-reactive and her whole body was rigid, all signs of a neurological insult. She had recently been transferred from the Gynecology ward to the Medicine ward given gingival bleeding and profound thrombocytopenia (low platelets; factors that contribute to blood clotting) of unclear etiology. In the next bed, an elderly female patient was in diabetic ketoacidosis ( a complication of uncontrolled diabetes) because the nurses weren’t giving her the appropriate medications in a timely fashion. I enjoy the intensity of the medical ward, but this was more than intense.

At that moment, I could feel the frustration growing, trying to undermine my sensibilities. But I closed my eyes just for a split second, long enough to say “Jesus.” I opened my eyes and the chaos seemingly became organized. I started thinking out loud, teaching, and making vital decisions all at the same time. In a calm tone, “Hillary, this patient is bleeding into her brain. A CT scan would confirm this but we don’t have that at our disposal. Start her on Mannitol and Dexamethasone NOW. Once you do that, inform the family of the change of events and of the poor prognosis.”  Next I found the nearest nurse and guided her to the bedside of the patient who was in DKA. ” I know you’re very busy and working hard, but realize that we all have a role to play in saving patients lives. You can save this lady! Would you please make sure that she gets her insulin and IV fluids as prescribed? Thank you”

We all face situations, people, bosses, bills, etc that make us lose our cool or create worry. It is at those moments that we should challenge ourselves to be the aroma of Christ. And remember, as my family would occasionally tell me, there are people watching you even when you don’t realize it. That reminds me of a scripture from 2 Corinthians 4:7-10. “But we have this treasure in jars of clay to show that this all-surpassing power is from God and not from us. We are hard pressed on every side, but not crushed; perplexed, but not in despair; persecuted but not abandoned; struck down, but not destroyed. We always carry around in our body the death of Jesus, so that the life of Jesus may also be revealed in our body.”

Good news! All the aforementioned patients are doing well. Specifically, to my surprise, the patient with the intracranial bleed markedly improved within 24 hours. She complained off a bad headache but was talking, walking, and ready to go home. The family wanted to go to Nairobi to seek the expertise of a Hematologist about the thrombocytopenia issue and so she left within 72 hours of that potentially fatal event.

I have found that its also very important to have an outlet. While here, I have been playing basketball, table tennis, and volleyball with local Kenyans to relieve the stresses of the day. It has also helped to build relationships and possibly lasting frienships with the people here. I feel so blessed to be here. I’m happy that everyday I can make a difference.

Have a blessed week. Remember 2 Corinthians 2:15.

Peace and blessings,

Darrell

Rainbow 1

Rainbow over the hospital grounds

A Cheerful Heart is Good Medicine

10/08/2009
by

Written on August 2, 2009

children 6Proverbs 17: 22 ” A cheerful heart is good medicine . . .”

This week was just a busy, challenging, and emotionally straining as prior work weeks here. Yet, amidst my interacts with both sick and dying patients this week, who spoke Swahili, Kipsigis, and other tribal languages, I was able to communicate with them in a universal language for which I did not need a translator — love.

Something as simple as a smile or a kind word can bring healing. Often times, when I encounter patients or family of patients around the hospital and do not have anyone to translate for me, I just smile and find that it becomes contagious. In addition, when I’m rounding with interns and asking them questions to challenge their clinical knowledge and they do an excellent job, I tell them. Being in their shoes before, I know first hand how good it feels to have your superior/supervisor/attending to complement and/or encourage you. Interestingly, in bible study, when everyone was asked how their week was, one of the interns remarked on how nice it was to get positive feedback. That little bit of kindness cost me nothing, but was priceless to the recipient.

Thursday afternoon, soon after finishing lunch, I was paged by an intern to come to the bedside of a patient who had just died. This was an elderly lady who had been admitted to the hospital the previous night secondary to symptomatic severe anemia, but who also had developed acute onset of shortness of breath that morning before rounds. During rounds, upon seeing her, I knew that her prognosis was poor. She was in obvious respiratory distress and despite being given 10 liters of oxygen via a face mask, her oxygen saturation was in the 70s. There were no beds in the ICU and no available ventilators in the hospitals. I thoroughly examined her and reviewed her chest Xray. There was no evidence of pneumonia or tuberculosis. Her history and physical exam were most consistent with a pulmonary embolism, but there was no way to prove it without a CT scan or EKG. Unfortunately, the hospital pharmacy does not have lytics (medicine used to dissolve life threatening clots). All we could do was make her more comfortable. As we left her bedside to round on the next patient, I told my intern to call the chaplain as she didn’t not look like she was going to make it. Nonetheless, I was paged after lunch by another intern who was informed that my patient had died. I hurried to her bedside only to find her son, seemingly close in age to me, standing at the foot of her bed with an expression of unbelief. He was young. I couldn’t help but think that hat could have been my mother on the bed. Words escaped me. Anything I could have said, he might not have understood anyway. I looked at him and just gave him a hug. One of the interns soon came to the bedside and helped me to translate. I explained what I thought happened and led to his mother’s passing. More importantly, I let him know that I was praying for his strength and I that I was there for him. Though my time with him could not take away the pain of losing his mother, he was very grateful.

In the same way, I’m grateful for all of your encouragement and prayers. It means a lot  to know that you are proud of me. It means a lot to know that I have so many loved ones and friends supporting me. Thanks for all the emails.

I have to give a special shout-out to Brittney (my girlfriend for the few of you who may not know) who has stayed up late (given the 7 hour time difference) every night to talk to me on Skype and who never forgets to tell me how much she loves me and misses me.

I love you all. Remember Proverbs 17:22 as you begin another week.

Be blessed,

Darrell

Even though I Walk Through the Valley of the Shadow of Death

10/08/2009
by

Written on July 27, 2009

Psalm 23: 4-5 (NIV) IMG_0193“Even though I walk through the valley of the shadow of death, I will fear no evil, for you are with me; your rod and your staff, they comfort me.”

As I reflect on last week and this past weekend, the predominately theme that resonates in my mind is death. And I keep asking myself, what could I have done differently? Could I have saved this patient? If I had all the resources I needed, would that have made a difference?

Out of 60 patients on the medical wards, six patients died over the past week. Two of them were in their 20s. Surprisingly, the family of these patients seem to be at more peace with the loss than I am. I want to save these patients and sometimes it’s hard for me to face the reality that there’s nothing I can do.

Indulge me as I take you to the bedside to see what I see. I will describe three of the cases. If you have a weak stomach, skip this part and scroll down to the section titled “A Success Story.”

Female Ward

At the beginning of the week, I was called to the bedside of patient who had advanced AIDS and who we were treating for severe anemia. She was thin, but not cachectic. She was covered with her blanket but on her face and head, I saw dark tumor-like lesions on her lips, face, and behind her ears. This was nothing new as I had previously recognized this to be Kaposi’s sarcoma, skin lesions that can arise in patients with advanced AIDS but not commonly seen in US. The reason I was asked to see her prior to rounds is because her skin was sloughing off. I pulled back the blanket and all over her abdomen, back, chest, and legs her skin was literally peeling off to reveal the reddened tissue underneath. It was like she was burned all over her body. She was in no obvious distress from this but was uncomfortable. This was no doubt an ominous sign. After quickly running through a list of differential diagnoses in my head, my top differential diagnosis was a medication side effect. One the medications she desperately needed had likely caused this. We treated with IV fluids to no avail. She died several days later. In talking with other physicians, there was nothing I could have done differently.

Male Ward

During the middle of the week, I was paged by one of the other Internal Medicine attendings to assist with a combative patient. When I arrived at the male ward, I saw a big commotion around one patient’s bed. There were two people restraining an elderly appearing (though only 56) slender male as blood poured from his nose. There was a puddle of blood next to his bed and his gown was covered in it. Apparently, he presented with an altered mental status of unclear etiology and epistaxis (nose bleeding).

His nose had to be packed. But how?! He was bleeding so profusely that merely packing it with gauzes wouldn’t help because he would end up swallowing the blood and later vomiting it. Or worse, the blood would end up in his lungs. But also, if you put a Foley catheter (commonly used to drain urine of the bladder, but has an inflatable balloon on the end) in his nasopharynx (nasal passage as it leads to the throat) as I did on a patient several days prior, you run the risk of him pulling it out and causing more damage. So I decided to pack it. So I ran to the emergency room (ironically called Casualty) to get my necessary supplies — iodine gauzes, adrenaline, and forceps. I ran back to the patient’s bedside and someone was holding pressure over the patient’s nose. Reluctantly, I asked them to remove the pressure so that I could see what I was dealing with. I couldn’t see much more than blood in his nose. I quickly squirted adrenaline (hoping to constrict the bleeding vessel) onto the gauze and shoved it as much of it as it could as far back as I could. This helped temporarily but did not solve the problem. We called the surgeons but, but they agreed with our management and did not want to pursue any further interventions.

So why was this happening? There was no trauma to explain it. Blood tests showed that his various blood cell lines were low. Again, I asked myself why? So we got a blood smear to look at his blood cells under the microscope. Suddenly, the clinical picture became clearer. He had acute leukemia (cancer of the blood). There wasn’t much we could do, but keep him comfortable. He was Muslim, but we still had the Chaplin to meet with him and his family. He died two days later.

ICU

Monday was an on-call night for me and it would prove to be a busy one, primarily because of a very sick patient in the ICU. He was a 23 year old male with hyperthyroidism (overactive thyroid gland) for years who was receiving poor care at home with no management of his thyroid disease. Apparently, his uncle noticed how poorly he was doing and decided to bring him to the hospital. The patient was admitted to the ICU on Sunday by another physician as I was off that day. When I rounded on him Monday morning, I knew that it was going to be a long day and night for me. He was an extremely wasted (thin; literally skin and bones) young male, barely verbally responsive with his eyes protruding out of the orbits (known as proptosis; a sign of advanced hyperthyroidism) and saliva running from the right corner of his mouth. But he was alive. He undoubtedly had thyrotoxicosis. His blood pressure was recorded as 74/50 but I assumed that it was mildly higher given that the adult blood pressure cuff was too large for his child-sized arms and his femoral (groin) pulse was bounding. His heart rate was in the 90s but was recently in the 130s prior to getting Propranolol (medication to decrease heart rate). He had a facemask on for oxygen delivery but there was no machine to tell us accurately what his oxygenation was.

Instinctively, you want to give a patient like this boluses of IV fluids. However, his clinical picture was also confounded by evidence of heart failure on physical exam and chest X-ray. Nonetheless, the physician who admitted him tried bolusing fluids which had caused him to require oxygen because the fluid pooled in his lungs. Eventually, I placed a large bore IV into his external jugular vein so that we could administer pressors (drugs designed to boost the blood pressure). This worked overnight, but overall his prognosis was poor.

Two days later, after bathing him  that afternoon, the nurse noticed that his pupils were fixed and dilated. He died.

A Success Story

Remember the case of the young university student who presented with symptoms that I had a hard time timing into an all encompassing diagnosis? The young lady who I was thinking about either a brain mass or meningitis? Well I treated with antibiotics empirically for bacterial meningitis. Her family was not able to afford to send her to another medical center for a CT scan. Nonetheless, she got better! I have no idea if the antibiotics did anything to help her but she is walking, talking, and ready to go home. It’s at times like these that I am reminded of the motto of the hospital, “We treat. Jesus Heals.”

My spirits remain high. I know that I’m making a difference. Death may come, but so does life.

Psalms 23: 6 (NIV) “Surely goodness and love will follow me all the days of my life, and I will dwell in the house of the Lord forever.”

Peace and blessings,

Darrell

IMG_0211

Beyond Tenwek

10/08/2009
by

Written on July 21, 2009

Hey family!

I pray all of you had a good weekend. I definitely enjoyed mine.

The Safari Club

On Friday morning, I traveled approximately 3 hours with a group of 7 people, who are also visiting physicians and nurses, across rocky dirt roads to Mara Safari Club. As we road through various towns on the way, our path was often crossed by herds of cattle or goats as their owner(s) led them to water or grazing fields. The land looked dry, mostly brown instead of the rich green color of their favorite tea leaves, as drought has been starving the land of moisture. So dry, in fact, that I often found myself coughing as the dirt and dust would easily lift from the ground and travel to my lungs as would rode toward Mara Safari Club. We would eventually arrive at the club, covered in dust. My ipod have a layer of dirt on it making the screen nearly opaque.

I did not know what to expect from Mara Safari Club, but when we arrived I knew that this would be just the experience that I wanted. There was a lady there welcoming us with moist hand towels to wipe our faces and hands while a gentleman standing nearby was ready to distribute tall cool glasses of freshly squeezed mango juice. This place had the touches of a 5 star hotel with the finest handmade African furniture and designs. During the orientation, we were told that we would have our own individual room attendant, waiter, and driver. Upon being escorted to our tents (yes, tents), the grounds were notable for an indoor/outdoor restaurant with view of the Mara river (with the sights and sounds of hippos from the river, monkeys in the trees, and colorful birds in the air), outdoor pool, and a Hippo viewing area. The tents were hugs and were no ordinary camping tents. It was complete with a king size bed with fine linens and a hot water bottle to heat the bed, leather furniture, modern designed bathroom and shower.

The Safari

Eventually, we would eat a IMG_0333gourmet meal and venture off to our first of four safaris for the weekend. I could honestly, write about the safari for days, but just imagine seeing giraffes, four types of gazelle, hyenas, wildebeest, elephants, buffalo, cheetahs, and lions in their natural environment cohabitating. Imagine the sounds. Imagine the sunsets and sunrises. Absolutely amazing! I even touched a rhino. Of course, I took hundreds of pictures that I look forward to sharing when I return. I’m going to try to attach some pictures to this email to give you an idea of what I was describing. However, because of this email network, I’m not sure if it will work.

The Maasai People

Prior to our afternoon safari trip, on the second day at Mara Safari club, we traveled to a Massai village. The Massai are a people indigenous to Kenya and have been one of the only tribes to preserve their culture over centuries. They are nomads, moving their village as they herd their cattle to different grazing areas and watering holes. The typically have hundreds of cattle which they do not sell, but use to sustain those within their village. The men are historically known as warriors. Decades ago, as a part of the transition into manhood, a boy had to kill a lion. However, this no longer occurs. They are a polygamous tribe and many have multiple  wives. One glaring physical characteristics of the Massai is their large sagging open ear lobes. Their ears are pierced at a young age (both men and women) and they continue to stretch the opening. They believe in one God, but only few are Christians. These few have been converted by missionaries who came to teach the Word.

Upon arriving to the Massai village, we were greeted by the chief of the village. The holes in his ear lobes were so large that he actually folded them on top of his ear. As many of the Massai, he was not a very robust man, but slender and approximately my height. He was adorned in cloth that was shaped in a sort of gown.

Surprisingly, his first words were (and I’m paraphrasing), “Welcome, the tour will be 1500 shillings (which is approximately $20). Right then and there, I knew that we were in for a show and not a real day in the of the Massai type of tour. My skepticism would later dissipate; however, when I learned that money goes towards building schools for their children and I actually saw the schools.  It would still be a show, but at least I felt a little better about it. However, as the only African-American amongst a group of white people, I couldn’t help but think of the old Sambo routines that exploited blacks.

Nonetheless, we entered the village and the chief began to give us a history of the Massai and describe their daily life. The things that I found most interesting, where the following: 1) after marriage, the wife builds the house (made of mud and cow dung) and cannot receive aid from her husband, 2) they use their cows for milk, meat, and BLOOD. They mix the blood with milk and drink it regularly and 3) They drink the water straight from the Mara River. This would prove to be a major problem as diarrheal issues and malaria are prevalent there. The chief was a very logical man, but said that if he asked his people to boil their water before drinking it, they would think he was crazy and not do it.

Who's the man??!!

Who's the man??!!

In the center of the village was a group of men, dancing and jumping. On the other side of the village were a group of women singing. Their children were scattered but were trying to imitate their parents. All around us was cow dung and flies, but the only people that were swatting flies and watching our step were us, the visitors.

Overall, I enjoyed my time with the Massai and in the safari, understanding that it was a once-in-a-lifetime experience.

One of the Most Touching Experiences of My Life

We retuned to Tenwek Hospital at around 230pm, too late for morning church service. However, one person recommended going to the African Gospel Church nearby with the understanding that it would be similar to last Sunday’s service except that it would be done in the native language of Swahili. It would be prove to be everything but what we expected.

We (Aaron, Ginnie, and I) opened the church doors and simultaneously at least 200 hundred Kenyan children lining the pues turned around toward us and started clapping and screaming in excitement. There was only one adult in the church, who appeared to be their teacher, and he informed us that they were excited to have visitors. He then asked us to walk to the stage and share scripture and song with the children. We were all caught off guard but also up for the challenge.

Upon walking on stage, I looked out and saw at least 200 hundred children, seemingly no child over 12, all dressed in their green and white boarding school outfits and smiling ear to ear. Each of us on the stage introduced ourselves and shared our favorite scriptures. I shared Philippians 4:6-9. We then tried to think of songs that the children would know and could sing with us. Ultimately , we would all sing “Jesus Loves Me” and “Amazing Grace.” We then flipped the script and asked them to sing for us. Imagine a sanctuary full of children singing in chorus. Absolutely beautiful! So much so that the woman next to me was about to cry. Not me of course. 😉

After this, the teacher asked us to talk to the children about America and give advice as to how they could change Kenya to be more like America. This misconception that America is “better” than Kenya is widespread. All of us on the stage were eager to refute this concept, but the gentleman to my left (Aaron) spoke up first. In so many words, he eloquently said that God loves us all, that God put them in Kenya instead of America for a purpose, and that people are no happier or blessed in America than  they are in Kenya. He said exactly what I was thinking. Needless to say, his comments were well received.

As soon as we walker off the stage, the children flocked us. I had so many children around me I could not move an inch. Children all around me were asking to shake my hand. It was very moving. As many children began asking me questions about me and my career, I realized that I was probably the first African-American they met. Though I was overjoyed with opportunity to share a word of encouragement with them and possibly positively impact on of their lives, I was also saddened by the fact that I was the only African-American. Why are such mission trips filled with white people eager to serve without a black face in the bunch? We, as a people, have to do better with serving our brothers and sisters in Christ around the world. Though a little off topic, this made me reflect on my own beliefs about adoption, specifically of white people adopting black children. If we aren’t going to do it, someone should.

That was an aside .  . . back to the children. So they were asking me everything from my name and age to how I became a doctor. They wanted to know what schools I attended and if I thought that they could do the same thing. I stopped in my tracks and told all of them to listen closely. I quoted another one of my favorite scriptures in the book of Matthew that reads, “Ask and it will be given to you; seek and you will find; knock and the door will be opened to you. For everyone who asks receives . . .” Furthermore, I encouraged them to put God first, stay in prayer, work hard in school, and never give up on their dreams.

After that, the teacher requested that I try to keep moving because the children would keep talking instead of going home to sleep. At that point, one of the little boys no older than 10, grabbed my hand and used his other hand to push through the crowd while telling his peers to make way. I felt like MLK or Gandhi for a moment. As I reflect on that night, I felt good about what I had done, but felt a sense of purpose about what still needs to be done. Reflect on the following: How will you help your brothers and sisters abroad? How can you improve the life of a child in the developing world?

Peace and blessings,

Darrell