When in Kenya...

...CLIMB MOUNT KENYA!! This past weekend was fantastic!! Three of the other volunteers and I decided to head to Mount Kenya, which is about a 4-hour drive from Nairobi. We stayed at the Mount Kenya Hostel, located at the base of the second highest mountain in Africa, which was beautiful in it's simplicity, rural setting, and genuine hospitality of its owners. Saturday we hiked from the entrance gate to the national park, up to the Met Station, which is at 3000 meters. The scenery was amazing and the weather was perfect--lots of sunshine with cool breezes. Bamboo forests, towering pines, streams of glacier water running down them, hearing the birds and occasional monkey, and always on the lookout for an elephant to saunter out of the brush (never did see one though). After resting at the station, which is the first campsite for those on the summit route, we continued on the trail, which got considerably steeper, til about 3500 meters, when the altitude got a little too much and walking 5 feet seemed like a mile! Eating lunch with the view of the Rift Valley from 3500 meters up was incredible!! We then headed back to the park gate and ended our first day of hiking with a few Tuskers and a great dinner back at the hostel. On Sunday, we hiked around the park with our destination being the Mau Mau caves, the hideout for Kenyan rebels who faught for independence against Britain. Crouching as we walked through them, with our flashlights spanning over the rock shelf where the general slept and the separate cave where they cooked their meals, and hearing how the British tried to infiltrate the spot by bombing the caves, but realizing how futile that was upon seeing the precarious perch of the caves in the side of Mount Kenya, was incredible!! Walking back through fields and sharing the trail with numerous cows, goats, and sheep, all the time Mount Kenya providing the perfect backdrop, made for a beautiful hike. The president of Kenya has it pretty good, as his 500-acre ranch sits at the base of Mount Kenya as well. Driving the four hours home, I couldn't help but think about how surreal it is to have been on bedrest for fear of throwing a clot a few weeks ago, and then spending this weekend hiking on Mount Kenya. It was an amazing weekend, my first that far away from the city, and the fresh air was just what I needed!

Another first for me last week was teaching!! Yep, that's right...I went with two of our new volunteers to the school I had visited a few weeks ago, called Hidden Talents, and was going to help them teach math to class (grade) 7, but after realizing square roots of fractions were completely over my head without a calculator, and seeing there was no teacher for class 8 who were supposed to be learning science (all teachers there are volunteers, and thus are not regularly scheduled), I wandered over, asked to see the one textbook they had (for about 25 students), then spent the next 45 minutes teaching them about skin!! We talked about pores, pigment, hair follicles, the dermis, epidermis, oil & sweat glands, bruises, scabs, scars, and they just soaked it all up like sponges...it was great!! I hope to return this week and teach again...we shall see.

Alas, my first GI distress since I got here came to a head today (pun intended), but I'm blaming it on too much Blue Band over the weekend, which is the Kenyan substitute for butter, or as I now call it, the magic bullet or rocket. I have a new appreciation for Pepto Bismol now, and I'm sticking close to the loo as it works itself out of my system. For those that I climbed Kili with, I'm at a stage 3 currently (yeah!) and I have a new respect for those that were doing anal kegels all the way up the Western Breach!! Will try to get to the orphanage today for the community football (soccer) game, but only if my intestines cooperate...

Time is flying!!

And it's definitely because I'm having a blast! So Monday of this week I spent most of the morning in the city trying to pick up some packages that have found their way to Kenya, and that have my name on them! Little bit of a hassle, but I should have them in my possession by Friday...hopefully. Later that morning, I helped another volunteer who is placed at a school in Kibera, the largest slum in all of Africa, teach swim class!! The pool is not far away, located on the grounds of one of the local universities. I had a blast! After the basics of freestyle, doggy paddle, and backstroke, we taught them handstands and how to play chicken!! It was great--they absolutely loved it and their giggles as they sat on our shoulders trying to push each other over was hysterical--I could hardly keep myself upright I was laughing so hard! Then I headed over to the orphanage, where they have a community football (soccer) game every Monday afternoon. Everyone from the community is invited to come, to play around with the kids for about an hour. So after going hardcore for the rest of the afternoon, I don't know where I found the energy to go for a run with another volunteer after we returned home, but that was an adventure in and of itself...I felt like I was training for the steeplechase due to the fact that the "sidewalks" here are basically rocky dirt paths with no less than 50 potholes in a 10 foot stretch, and you have to weave in and out of several types of obstacles...which could range from animals, people, bushes (with thorns), huge puddles that turn into small lakes when it rains...you get the picture. Running for 20 minutes felt like a marathon in a cross-country course! Tuesday I realized I might have overdone it with all the exercise from the day before, so I will try to do a better job of pacing myself the rest of this week. Today I have just returned from visiting another hospital, this one located in Kikuyu, about a 45-minute matatu ride outside of Nairobi. It was started by the Presbyterian Church of Eastern Africa, and the hospital campus itself is beautiful, the focal point being the first PCEA church to be built in all of Kenya. Then the hospital itself spreads out from there, with a different building for each ward and department, all connected by open breezeways and walkways lined with the most beautiful plants and flowers. I first visited the rehabilitation center which is a short 5-minute walk down a hill from the main hospital campus. The physical therapists there answered some questions and showed me around, then pointed me in the direction of the main campus, where I found the occupational therapist, who was busy attending to an outpatient that was coming in with a 3-week old transmetacarpal amputation of his dominant right hand due to a work injury--he got his hand stuck in a machine that is responsible for shearing hot pieces of metal into sections. We also saw a man in the ER that had fallen that morning and needed a wrist cock-up splint for his dislocated right wrist. I spent about 3 hours with this OT, who was so happy to show me her work and ask for my input on different things. She shared with me that the majority of the cases she sees are injuries from the local steel factory (amputations like the first patient I saw), as well as pediatric patients with cerebral palsy. She has been working at the hospital for a year and is still waiting on getting basic equipment, so she has been substituting what she can with the PT equipment. She would love to come to the US to get her masters degree, then return to Kenya, to her people, not forgetting her roots and where she came from, because as she told me, "Roots are what make you stand up." She was just the most amazing person to talk to about our shared profession, and see her in action with a few patients. Visiting these different hospitals and talking with the OTs has given me a much deeper insight into the culture here as well, so I'm going to try and visit one or two more before I leave.

I'm really starting to feel like a member of the community, too, not just a tourist with a cause. Being greeted on the street by people I've met by visiting the different projects i-to-i is involved with, as well as feeling like a regular at the places we frequent all the time, really makes a difference, as it took me a few weeks to get accustomed to the stares and attention my white skin tends to draw. I still can't believe this is my 5th week and I only have 2 more to go after this one! Still waiting to hear what my project will be in Tanzania, but I'll be sure to let you all know as soon as I find out. Oh, little promo here...be sure to check out my friends' blogs listed on the right side of this page, who will be travelling to New Orleans to help rebuild with Habitat for Humanity, and the others who have relocated to Ireland for the year!

Celebrated Fat Tuesday with a chocolate frosted donut and a chocolate milkshake last night--that was the most junk food I've had since I've been here...my system is still recuperating!! And for those of you that are familiar with it, I have introduced "Nutsy" to the other volunteers, and they love it--can't get enough of it!! For those of you that have no idea what I'm referring to, Nutsy is probably the best card game ever invented! So to all my friends and relatives that know and love the game...Nutsy has gone global!!

And I think I'll end with one of my favorite memories from when I was in Africa 2 years ago that I was reminded of Monday night...the night skies here are fabulous!! On top of the highest mountain on the continent, you feel like you could just reach up and grab a star! Well, back in Africa and not as high up this time, the stars are still spectacular!! I swear there are twice as many and they look so much brighter here! The moon was absolutely incredible the other night, just a sliver, but the whole of it was silhouetted, which I've never seen before!! Was pretty excited to see a shooting star as well! And yes, I made a wish...

Climb every mountain...

What a weekend!!! Now that I'm able to get about and actually do things, using my muscles and not having to be afraid of dislodging a clot, I'm raring to go!!! On Saturday, one of the other volunteers who is placed teaching at a local school, rented a bus with funds she had raised before coming here, and took classes (grades) 6, 7, and 8, about 66 students total, plus a few teachers and some of the other volunteers (including me!) totaling about 10 adults, to Ngong Hills, just outside of Nairobi. There are 7 hills total, some as high as 1500-2000 meters, and we traversed about half of them after picking up our armed guard to take with us (the area is known for a high rate of robbery), then headed back to the bus. We had absolutely beautiful weather--lots of sunshine and a breeze the whole time, although it got a bit gusty at the top of each hill. Got a little too much sun, but the leg felt great and it was such a good feeling to get outside of the city and see some of the rural areas for the day. Being with the kids was awesome too, as for most of them, this was their first time outside of the city. Come to think of it...for both them and me (since I haven't seen anything but the inside of hospitals since I got here)!! It was a great day, and we had a blast! Some of the girls from class 8 even tought me a contemporary hip hop song in Swahili as we were trekking back down...and I have to say I mastered both the words and the dance by the time we reached the bottom...I have the music video to prove it! It was just amazing to hang out with this group, as they were taking it all in and looking down on their home city and seeing the surrounding countryside. Funny how the best moments in my life have been on mountaintops...so clear, with people that mean a lot to you, and everything in the world looks so small from your vantage point no matter what's been troubling you, reminding you of what's really important in life.

Today started with brunch at a delicious restaurant called Nairobi Java House...mostly western-style food, so I ordered the pancakes...they were amazing! Nice to have a taste of home! Then we spent the afternoon at the giraffe center, just outside the city. It's special center that houses about 20 giraffes, and they have built a special elevated platform that lets the giraffes come right up at eye level to you! A giraffe ate right out of my hand!! Have the pictures to prove that too! They have the most beautiful eyes--sort of like Jersey cow-amber brown, with the longest eyelashes ever! And did you know that giraffes have a special capillary system that runs the length of their necks to circulate the blood all that distance; if they had the same as ours, they would pass out every time they bent their heads down. And a giraffe only sleeps for about 15 minutes every day...amazing I know! Once I get home, I promise to post pictures so you too can experience all these adventures! The connection here is so slow that I am not able to upload anything in a reasonable amount of time.

So my first weekend that hasn't involved any medical care or recuperation!! Thought you would all like to hear about it! Stay tuned as I only have 3 weeks left!!

Week #4

Well, a whole week has passed and no more hospitalizations...I'd say that's an accomplishment for me!! On Sunday I went to church with two other volunteers and our housekeeper, who had invited us to go with her. I definitely had a lot to be thankful for after the past two weeks. What an experience...the 3-hour service was held in the newly constructed church--corrugated tin walls and roof, and if you can just imagine the sounds of all those voices joining together to sing and worship resonating off the tin...it was incredible! I even recognized a few songs...Blessed Assurance and Oh Happy Day!! And God provided the perfect illustration for the pastor's sermon...there was a terrific downpour midway through his message on baptism!! He had to shout so we could hear him because the rain was coming down so hard against the tin! Since we were there visiting, they translated everything into English for us, so it was one sentence English, then repeated in Kiswahili, which we were very grateful for.

Monday was absolutely wonderful as I went back to the orphanage...I was so happy too see the kids. Tuesday I made a visit with some other volunteers to a school called Hidden Talents in Kawangware, the same slum the orphanage is located in. It was an amazing project and one we're trying to convince i-to-i to get involved with. The school was started by a pastor, who began his work back in 1993 feeding orphans on the streets of Nairobi. He then gathered the funds and ground necessary to build the school, which now houses about 1250 students. Since they only have less than an acre, they've just built upwards, and are also building additions to the primary (elementary) school across the street and working on acquiring funds to build satellite locations all over Kenya to send orphans to live and attend school. This man had probably one of the strongest visions of bettering his community that I have ever encountered...he was truly inspirational as he told us about his work and the center's motto: "We do everything by faith," and his belief that every child has a talent, it just needs to be nurtured. So they focus on both athletics and academics. The part that affected me the most though was seeing the line of people waiting outside the school, and learning that these were guardians waiting to be interviewed by the pastor in order to bring children to the school. Then seeing the files full of death certificates that the pastor has stacked in his office, stapled to the guardian certificates he's received from the government indicating that he is now responsible for the orphans the individuals have left behind. I couldn't stop the tears as I read certificate after certificate, and I was reminded that it never says "AIDS" as the cause of death, rather some form of immuno-suppression. It was a sobering reminder that this disease has far-reaching effects, never stopping at just one generation...even if the children are blessed enough not to be infected during birth or in infancy, they most likely will be orphaned at a very young age. The visit to the school ended with a stop in the pastor's office, who beamed as he showed us trophy after trophy of various graduates...the fastest runner in Kenya for the 100m dash, a football (soccer) player for the French World Cup team, and the list goes on and on. I hope to get involved with this school at least once a week for the remainder of my time here, as they have about 40 teachers, who are all volunteers.

Wednesday, I had a follow-up with the doctor after getting my blood checked. My numbers are stable and he was very pleased with my progress, not wanting to check me again for two weeks, and if those numbers are ok, he'll see me once more before I fly out to Tanzania and set me up with enough warfarin/blood thinners to last me the 6 weeks I'll be there, and then I'll be able to test myself while I'm in Tanzania with my portable INR/PT self-test machine that is on its way to me. Quite the set-up I know, but has to be done. I was reminded this week of how blessed I was that it wasn't worse, as another volunteer flew home early with typhoid and his fourth go-round with malaria, and another volunteer was hospitalized and had to undergo surgery to have his appendix out. My leg is almost back to normal, only aching when I find myself sitting with my legs down or standing for a long period of time, but it goes away if I start moving around, which the doctor said is completely normal. My muscles are getting stronger every day--the kids at the orphanage are seeing to that! As it was Valentine's Day on Wednesday, we brought in special heart stickers and a huge new set of markers, crayons, and colored pencils--and they just loved it--by the end of the morning, we were all covered in stickers!

Thursday I made a trip to Nairobi Hospital again, only this time it was to meet with the occupational therapists there!! I talked to them for about an hour, and it was neat to hear their work is very similar to mine back home--seeing patients bedside as well as on an outpatient basis. For all those OT's out there, cones are universal--they had a stack there in the outpatient gym! They also gave me a list of other hospitals and clinics in Nairobi that employed occupational therapists, so I hope to get to one or two a week and see what they do at each facility.

Friday has been the best day so far--I went along with one of the other volunteers to her project, which is a support center for women with HIV/AIDS. Their main focus is garment and accessories construction for these women to earn an income, and the other volunteer had ordered school uniforms for all the kids at the orphanage I'm volunteering at, purchasing them with funds she raised by doing an 8-mile run back home prior to coming here. Picking up the uniforms at the women's center, and seeing those women with huge smiles on their faces, so proud of the work they had done, and then getting to the orphanage and helping distribute the uniforms...the kids couldn't wait to put them on, not even bothering to take off what they were already wearing!! The girls twirled in their dresses and the boys were strutting all around in their shorts--it was fantastic!! The teacher just kept saying, "Now they look like a real class!" It was great!

As for expanding my cultural experiences, I tried Ethiopian food for the first time a few weeks ago--eating from a huge communal plate with our hands was definitely a highlight! As a house, the other volunteers and I went out for Indian on Valentine's Day. Really looking forward to having a nice juicy steak though when I get home, as the fear of Rift Valley Fever is limiting meat consumption in the whole region. My command of Swahili increases daily, as I learn new phrases and am reminded of those I've already learned, just forgot :)

The weather here has continued to be warm, with plenty of sunshine every day, although midday storms have been rolling in a few days a week, and the rain is a welcome refresher, cooling everything off and settling all the dust!

So that's what I've been up to...hard to believe I only have 3 weeks left here. And I find myself looking at my to-do list and wondering where the time went, as there's still so much I want to do!! Granted, 2 weeks were spent "sojourning," as one person put it when I shared that I felt I had wasted 2 weeks..."a little diversion the Lord provided to give you a new perspective."

Round 3...

OK, I know it's been awhile since my last blog entry, but I have a pretty good excuse. Originally scheduled to follow-up with the doctor on Wednesday the 7th, after finishing my antibiotic course, I trekked into the city and returned to him on Monday the 5th instead, as my left leg was not getting any better and the stiffness & ache were persistent, despite elevation, hot compresses, and Cipro coming out of my ears. The good doctor ordered an x-ray, to rule out bone infection. Back down to the diagnostic imaging clinic I went, where I just was the week before for my doppler ultrasound (which I'll remind everyone showed no evidence of DVT). The x-ray was completely normal, and I trudged back up to the doctor, who then referred me to a general surgeon at Nairobi Hospital for a second opinion. Make my way over to the doctors' plaza there, and after taking my complete history and symptoms, tells me we have to rule out a clot indefinitely, as I have the classic symptoms and a doppler is not 100% accurate (a fact I did not know). He orders a venogram, makes a call to the radiologist, and gets me in the same day. Now, what I have related thus far probably sounds like it went very smoothly and progressed at a fairly quick pace. In reality, my Monday started at 9am and I found myself sitting in radiology around 4:30-5ish. My emotions at this point have been a roller coaster, and all the waiting has not helped slow down my brain that's moving at a million miles an hour. Just imagine, I have been assured twice now that I have no clot in my leg, relieved of my original suspicions, and now I am faced again with the possibility of having one. As I lay on the table, with the contrast dye being injected into my foot, the radiologist surveys the screen as the dye spreads up the veins in my left leg. I crane my neck to see what he's seeing. I can't quite explain in words my thoughts when the radiologist says to the tech operating the scan, "Stop it right there, I can see the thrombus." I can't stop the tears at this point, barely able to see the white strip in my distal femoral vein that appears about 2-3 inches in length, as I realize what this means--I have a DVT, deep vein thrombosis, that I've been walking all over Nairobi with for the past 2 weeks...the feeling of waste at being down and out for 2 weeks when I'm here to volunteer, how this is a black mark on my medical history forever--worse than getting an F on a school paper, but probably the most severe thoughts going through my head are the what if's, and that scares me more than anything--thinking of what could have happened. Everything is a blur until the general surgeon appears in front of me, saying things like "admission" "anticoagulation treatment" and "observation", as I am led to the admission desk, then up to the short stay or overflow ward, since the hospital is completely full. This place is a Hilton compared to the other hospital I was at...I'm told later that all the diplomats and VIP's are brought here for treatment--glad I have that travel insurance to cover this bill. One of the other volunteers has been great and has been with me through this whole process, contacting our in-country coordinator and getting a list of things I'd like to have brought back to have in the hospital. I am placed on strict bedrest, but bargain to have bathroom privileges (I refuse to use a bedpan!)...we compromise on a bedside commode. I am started on subcutaneous clexane (heparin) injections and oral warfarin. As the buzz of being admitted dies down and I'm left alone, I dissolve completely--yep, full BD (breakdown), finally letting all the frustration, anxiety, anger, being scared, unsure, out of my system. Relief starts to settle in after about an hour, just having a diagnosis and receiving the correct treatment. Prayer has been a constant the whole day, and I find myself thanking God that I didn't throw a clot...lose a leg...just to be alive! Three of the volunteers at the house stop by later to visit and bring me my stuff, along with some goodies. It's a good feeling to have a "family" being so far from home, something I come to appreciate even more as the week goes on--the volunteers are so good about coming to visit me, organizing shifts and bringing in contraband with each visit...I swear I'm going to weigh 100 pounds more eating all of it and being on bedrest--good thing they let me share with them. I'm given a sleep aid that first night (and every night after), as if I need it I'm so exhausted (later find out the sleep aid is none other than Rohypnol, or more commonly known as Rufies...). Tuesday morning the general surgeon gives my case over to a cardiologist, who then reviews my history and symptoms with me, then goes over the treatment plan. Late Tuesday I'm transferred to the MCF ward, with a private room to my surprise, making sure I still get to have a commode. Amazing how the things we do everyday without thinking become such an ordeal when you're on bedrest. Realize the irony of how I left my job working at a hospital to come volunteer, and now that I'm here to volunteer, I'm stuck in a hospital...getting a whole new appreciation what it's like to be a patient. Wednesday and Thursday pass by pretty much the same, except Thursday I get to go for an abdominal ultrasound to make sure a tumor wasn't the cause for the clot, with my history, which comes back completely normal. The cardiologist rounds every morning to review my INR from each morning's wake up call blood draw, and then again in the late afternoon to make sure I'm doing ok, assuring me from the very beginning that Friday is the latest he'll keep. But by Friday, the excitement of getting out of there is drowned out by 1) going out of my mind with boredom being on bedrest the whole week and 2) my discharge being held up by insurance issues. Finally get things straightened out, and as I WALK out of the hospital--have never felt better! Walking into the volunteer house and getting hugs all around, taking a shower, and sleeping in a familiar bed that night are just wonderful! So I have a few more bruises now since I'm on warfarin daily (for the next 6 months to a year), I get to wear these very sexy compression stockings during the day (not so comfortable in 80-degree temperatures), and I have a follow-up with the blood lab and the cardiologist on Wednesday the 14th, which will probably be a weekly occurence, then monthly until he's assured my blood levels are stabilized since this was a spontaneous clot. Also have to look into getting a self-test INR machine (sort of like diabetics have to do with their blood sugar) so that I can check my own levels once a month after I leave Kenya. Not the best thing to have to deal with from now on, especially with all the travelling I have ahead of me, but my leg finally feels better, and I can get on with what I came here to do. Today, Saturday the 10th, I went with some other volunteers to visit the orphanage, and just to have those kids that I haven't seen for 2 weeks and have only spent 1 week with so far yelling out my name and running up to me as I walked through the gate was the best medicine ever! Now I sit here in the internet cafe, with my leg elevated of course or constantly moving to keep the blood flowing, updating all of you back home. Thank you from the bottom of my heart for all the love and support--to be so lifted up by so many prayers through this whole ordeal has truly made all the difference.