Kenyan Meal

During our time in Kenya we really ate like royalty. It's funny because I packed bags of snacks ( granola bars, trail mix, jerky, and more) thinking I really wouldn't eat that much. But, once again, I forgot. I had forgotten how much I love the food there. Call me crazy, it's ok. :-)

Pictured above is one of our usual dinners. I will do my best to describe the food to you. Your mouth may not be watering right now, but after one bite of chapati you will want it every day!

Teeny Tiny Bananas: Though small, they are scrumptious. And a safe fruit to eat on our own without worrying about getting sick. They are literally as big as my finger but completed any meal!

Chapati: ( by the bananas, looks like tortillas) I am in love with chapati. We had a cooking lesson where we learned how to make it. Once we are back from the wedding weekend I plan on introducing Trav. It is kind of a mix between a tortilla and flat bread. It is cooked on the griddle and so, so, so yummy!

Kachumbar:  ( behind chapati, red dish) A mix of chopped tomatoes and onions with a little pepper. 

(and probably something else) Surprisingly, a dish that seems so plain was so good! You usually eat it with ugali and one night we put it on noodles which was excellent.

Goat ribs: The first night we had them I devoured mine. They were so good! i was assuming it was chicken. No, that is a lie. It was darker than chicken but I guess I didn't want to question the source of my protein. Joel made a joke that one of the guard dogs was missing. Low and behold when we were finished we learned it was goat. First time I had it and loved it.

Ugali: ( the big, white ball) Ugali is a staple in Kenya. In the villages, it is eaten everyday. Usually the kids just get one serving of ugali each day. That's all they eat. If they are lucky they may have beans served with it or sukuma wiki. But since they all have maize crops it is the easiest and cheapest form of food. It is also served with meals at restaurants. You usually eat it by rolling it up with your fingers and dipping or scooping up the side dish with it.

Sukuma Wiki: ( the bowl of greens ) A make shift veggie stew. Usually kale, I believe. ( my mom would be proud I ate it!) The name itself means " stretch the week" because when they eat it they make it last a really long time.

So, as you can see, we did not go unfed. Instead, we ate traditional Kenyan meals and fell in love with some! Ooo, I am craving a warm piece of chapati right now!

Clinic begins!

Our first day of clinic was here! I would like to say I bounded out of bed. But it definitely took some stretching, yawning, and a," can't I just hit my snooze for 5 more minutes?" to get up. I will say though, it felt great to put scrubs back on. We organized everything we would need for the day than headed up to the big guest house for breakfast. ( ok, and some much needed coffee!) Once again we were spoiled by the ladies in the kitchen with a breakfast feast! The vans were packed and we were off!

( Please note in this picture the helmet was totally necessary. If you sat in that seat as a man you were guaranteed a head injury. Earl learned the hard way on the drive to Atemo.)

There was something I had forgotten about the last trip. The drives. As we road through Atemo than on to the dirt roads leading to the clinic, kids lined the streets shouting, "Mazungos! Mazungos!" You would hear squeals as they first looked at the vans coming down the road and than saw they were filled with Americans. Out in the fields men and women would stop their plowing or planting to stand up straight and watch us drive by. We were constantly waving and I don't think you could wipe the smiles off our faces as we waved to these little ones.

As we pulled into the clinic compound our eyes grew wide as we saw there was a crowd waiting for us. The word was out: American doctors are in town! Most of the kids stared right back with wide eyes as the strange white people unloaded the vans. Surprisingly, clinic was set up rather quickly and before I knew it I had my first patient!

Yes, it was a child. I knew right than it was going to be a great day because I already was able to snuggle a sweet Kenyan. We moved at a fast pace. The triage station was right outside my room and I often would grab patients to triage myself to help the flow and also, if you recall from my post here, I was slightly timid prescribing and diagnosing on my first day. There was a good amount of women that came through my door that day, all complaining of back pain, headaches, inability to sleep, and pain "everywhere." I prescribed them pain meds but I wanted to say, " Let me give you a day off. How about you just go rest and relax. I'll walk the miles and get your water for you today." Think about that. How often to you find yourself saying," I'm tired. It's been one of those days and I need a break. To just get away and have time to myself." I do it all the time which is comical because I am unemployed, no longer a student, and I don't have children. These women don't know what time to themselves or simply relaxing for a day is. I would give anything to have taken their workload for a day so they could rest. But, instead, along with their pain meds, they were given a warm smile, a casual hug, or a gentle rub on their back.

Above are pictures of patients waiting outside the pharmacy for their meds as well as the inside of the pharmacy in Tala. Let me tell you, these ladies worked hard! For each person who came to the window there were 2-3 prescriptions that needed to be filled for each member of the family of 4-5. They stood on their feet all day and never once complained. They were quite the pair!

Joel and Brenton were hard at work treating patients all day. Sharing their room was a Kenyan doctor as well. I could hear them talking from where I was in my room and I would listen in as Joel explained everything in great detail to Brenton, who being pre-med soaked it all up. Joel is great with all who come through the door but he is especially great with the kids. I could hear the slaps of high fives and the compliments on "princess" dresses. The kids loved him just as much!

It amazes me also how there was a constant patient flow all day. Never a lull or a lag. Just one after the other from start to finish. And they all waited so long. I get beyond impatient if I have a doctors appointment and they do not call me back on time. Yet these people come early in the morning and hang out all day long until it is their turn. Some even get sent away, unseen, when clinic is over.

 

I had to sneak away at times to check on the kids outside. Sometimes I wondered why they were staring at me so weird because I forgot that my white skin stuck out to them. I look back at the pictures I have with the kids and I can't help but see the absolute beauty of our skin colors next to each other.

Taking pictures of all the kids was a hoot because they all love seeing themselves on the screen afterward. They would squeal and shriek, some even were a little shy, as they picked each other out of the pictures. Even the moms and grandmas liked to see them too! 

Our first day of clinic was a great success. ( Well, minus my ooops incident but I will write about that in a different post!) Driving home was similar to the drive to clinic as we all waved to kids the whole way home. Dinner was once again a feast and we were so spoiled by our chefs! The night ended with starting a game of "Phase 10" that would later be known as "Skip Larry" only to be played every night until usually midnight. Who needs sleep, right?

After a great first day we were ready for another day of clinic, another day to be God's hands there in Kenya, to love on His precious people, and another day to let His light shine through us.

Elephants Play Soccer & Drink From Bottles

We landed in Nairobi early in the morning after flying for 17 hours plus an 8 hour layover. It felt great to get off the plane. We breezed through customs, loaded up our 24 bags, and were greeted with warm smiles from Lorna Meeker ( Pastor Meeker's wife) and Emmanuel, one of our drivers. Since our flight to Kisumu did not leave until 6pm that evening, we decided to do a little shopping in Nairobi. But first, shower! By this time most of us had been wearing the same thing for 3 days and I hadn't shower in just as long. The ELC-K guest house is located on Embassy row in Nairobi. If you remember pictures from my last trip we stayed here our first night. ( and we would stay here our last night on this trip.) The room in the picture below is the same room I had previously :-)

Driving through the streets of Nairobi brought back memories. It's crowded and the driving is insane yet I love it. We headed to a shopping center to start our souvenir shopping. We all found some good finds and than Scarlet said she had a surprise for us but we had to hurry to make it in time. None of us had a clue what it could be. Before we knew it we were driving on dirt roads through bushes to what looked like that middle of nowhere. We pulled into a make shift parking lot and Dr. Larry said, " What are we doing? Feeding lions out here?!" Scarlet grinned mischievously and said, "No, baby elephants!" 

Pretty cool, huh? They were really cute and really hairy! Never did I imagined that an elephant would be so hairy but they are! These elephants are all rescued from the wild. Most of their mom's were killed for their tusks and the babies were found close by. With no chance of survival, they are rescued and brought here to be taken care of until they are old enough to head back out to fend for themselves. And yes, they drink out of bottles. It's a baby formula much like the ones here in the states. 

They also play soccer  =)

These adorable kids were on a field trip!

Mud bath time!

Pumbas =)

While leaving the baby elephant are we stopped to see a RHINO! When I did the safari a few years ago, over a course of 3 days we never saw a rhino. And now there was one inches from my face. He walked right up to the gate and put his horn to it. Pastor Earl stuck out his hand and grabbed it. Katelyn and I followed suit and the next thing you know we were petting a real, live rhino. :-)

It was lunchtime so we headed to the Java House which is delish! Their coffee is famous much like Starbucks is here but they serve really good food also. After that it was back to the airport to fly to Kisumu! ( Please notice the hand written air plane tickets!)

Touching down in Kisumu was such an incredible feeling. As we drove on the bumpy roads to the village of Atemo it felt as if I was coming home. You know that feeling when you go back to your parents house after being gone. Where everything smells the same, sounds the same, and you feel safe...where you are right where you are supposed to be. That is what it felt like returning to Atemo. 

We stayed on the compound that housed the clinic from last time. There are some guest homes there, mingled in with homes where Lutheran missionaries are living as well as Kenyan seminary students who are attending the Lutheran sem in Kenya. ( This made my mom feel better!) As I stepped out of the van with my back to the house I heard my name called out. I turned to see a Kenyan man saying, " Emma! Emma!" as he walked towards me. He greeted me with a hug while saying." You came back! You came back! What took you so long?" I still tear up thinking about Joshua. A man I saw maybe for a day two years ago and here he was, shouting my name and hugging me. Welcoming me back to his village. 

 The house where Katelyn, Larry, Brenton, and I stayed

The main guest house where the others slept, where we ate, showered, & played cards till midnight!

After a delicious Kenyan dinner ( of course with Chapati), sorting of medications we would take and a cold shower it was off to bed. Snuggled up under my mosquito net with my flashlight close by I was out for the night. The next morning we would begin our clinics and I couldn't wait!

Emma Hardeman....NP?!?

At home in California I am a licensed registered nurse. In the villages scattering the Kenyan countryside, I am a Nurse Practitioner. You may wonder the difference. An NP can assess further, diagnose, treat, and write prescriptions all based on their judgement. Pretty stinkin' cool, right? After the first day, yes. 


My previous trip to Kenya I worked mainly in the pharmacy but was able to triage a few times. I figured on this trip I would be in the triaging room taking vitals, writing down chief complaints, and so forth. Never did I imagine I would be doing what I ended up doing. The first day of clinic they put me in my own room and before I knew it I had patients waiting outside just to see me. Yikes! I still did their vitals, I still snuggled the kids, I still loved the elderly, but now I needed to make my own diagnosis on what was wrong. Oh man, I was nervous! I found myself just treating the minor issues like back pain, generalized body pain, healthy individuals who just needed vitamins, and mom's who were not sleeping well. I would still send every other case to the doctor because I wanted to make sure they received the help they needed. I didn't want to screw up.

Being a new graduate nurse I haven't done much. I'll be honest, you can only do so much in school and compared to the real world of working on your own in a hospital, it's nothing. My confidence as a nurse is pretty low because I have zippo experience. I was feeling silly running back and forth from the doctor's room to ask him questions or figure out a medication. That night, as I laid under my mosquito net and after I was finished praying that no bugs would attack me in my sleep, I prayed for confidence. I prayed that God would use me in great and mighty ways with the people in these villages. I prayed I would go with my gut in situations and that I wouldn't feel like I wasn't measuring up to people's expectations. I prayed I wouldn't feel intimidated working with Joel, a man who is so knowledgeable and confident it leaves me in awe. ( I guess that is a good thing for an ER doc!)

We have a funny God ad the next morning at clinic we were short a room and what did I have to do? Share with Joel. So every assessment I made, every treatment I did, every 'script I wrote, and each teaching I gave he was right there watching. Yikes! God has a good sense of humor, doesn't He?! It ended up being the best thing for me. I learned more that day than I did sitting in lectures at school. As he taught Brenton about each patient, I would tune in picking up snippets that will help me in my own practice. 


Because of Joel, because of being thrown in on my own to work in a position that is higher than my training, I am going to go into my first job with experience that most people won't have had. 


Here is some of what I did as an NP:

Labs: I drew blood more times than I can count. It is harder on African skin and I didn't have a tourniquet. I learned to go just by looking and feeling. After drawing blood I would put a few drops in the i-STAT and receive my patients lab work in a few minutes.

Injections: Well, you do tons of these as a nurse but I can't tell you how many I did on this trip. I could draw them up and give them with my eyes closed now.

Diagnosed: I can tell you the difference between ear infections just by looking in some one's ear now. I can look at a person and know exactly what tropical disease they have. I can see a child and know if it is viral or bacterial infection without needing to do anything further.

Exams: Joel would send me his patients after awhile and I learned to do vaginal exams, breast exams, and more. I learned what to feel for, what is abnormal, and how to treat different scenarios. 
STDs: We saw them all, many times, and unfortunately I can now take one look and tell ya what it is and what the treatment will be.
Meds: Because I was a given a list of medications in the names we are not familiar with ( it didn't say Tylenol but acetaminophen) I now know my drugs like the back of my hand. How they work, their classes, different things they can be used for, and....pediatric doses. 

Fungal infections: There was alot of them and many different kinds. Some look pretty similar and others distinctive. I'm glad I was able to learn how to assess, diagnose, and treat them!
Wounds: We saw quite a few as well. The last clinic day I did more wound dressings than I have even watched in school. I learned about different ways to treat them based on the cause and different ways to dress them. 

To think that is just a handful of responsibilities I had. I loved being able to hold my own exams. The first few days the kids would sit on my lap in the chair with me. The last day, my room had this huge table that we would put a mattress on when it was time for an exam but any other time there weren't enough chairs in the room so my patients and translators would sit in the chairs while I sat on the edge of the table. I usually always had a kid on my lap and their siblings next to me on each side. They loved holding my stethoscope or letting them take their siblings temperature when I was done. Those kids are just too much fun. 

I learned many things on this trip but one thing that surprised me is that I liked the role of an NP. Of course I want to work bedside for many years, but now I know that someday when our kids are older I want to pursue my NP license. 

What an experience for a little new graduate RN! 

24 Bags? Check!

Saturday morning came awfully early as I waited until late the night before to pack for Kenya. Trav dropped me at the airport, I was checked in and ready to go. Now, I will admit there are times when I really do have "blonde moments" and I chose this particular morning to let me hair color shine. I was at the airport 2 hours early and I missed my flight. How? Because I was sitting at the wrong gate! When it was time for my plane to leave I realized everyone who was boarding was going to Hawaii and I literally ran geographics through my head saying, " How can they stop in Atlanta on their way there?" Oh man. Thankfully, I caught a flight that left shortly after!


5 hours later I touched down in Atlanta. I'm sure people laughed as I ran to catch my hotel shuttle while dragging two 50lb suitcases and two carry on bags behind me! Arriving at the hotel to meet the team I saw a familiar redhead and heard a friendly voice; Scarlet, our team leader. Although I have not seen her in two years, that day it felt like it had only been a week. The rest of the team greeted me warmly, making me feel right at home. I am amazed at how on trips like this you have an instant bond with each other. You are all there for the same purpose and no matter what your background is or where you are from there is an incredible bond from the start. Here is a glimpse at our team. That way when you see pics or hear stories you will know who is who!

Joel: An ER physician from Albany, GA and Scarlet's husband. He has been going on medical mission trips for over 10 years. 
Scarlet: Pharmacist from Albany who takes on more than most people can handle yet always wears a smile! 
Pastor Earl: From a small Lutheran Church in Tifton, GA this was his first mission trip. 
Delana: A retired registered nurse from Albany, GA with a heart of service still. This would also be her first medical missions trip!
Katelyn: My roomie =) A pharm student at UGA and a heart of gold. She had been to Jamaica and Peru on mission trips but this would be her first where she would use her passion, knowledge, and skills to touch others.
Brenton: Pre-med at UGA and a desire to learn already. He as well had been on trips before and was anxious to shadow Joel, soaking up all he could.


A mixed group of people with one common goal: to be a light and show God's love to the people outside of Atemo. 


That night we went out to eat for our last supper. And did we ever eat. I haven't been so full in a long time. They sure know how to cook in the south. My mashed sweet potatoes and Oreo cheesecake was to die for! Plus, I was introduced to sweet tea. ( not without a little ridiculing that the California girl had never heard of it ;) The next morning we took our last shower for....what was it Katelyn, 3 days? Pastor Earl led a beautiful church service in the meeting room at the hotel and than we got to our packing party. Scarlet was given special permission for each of us to take three suitcases totalling 24 bags. All full of medicine and supplies for the clinics. Sorted, weighed, tagged, each one was carefully prepped for the trip. I am pretty sure we had to use all of the hotels baggage carts to get them to the shuttle.

Packing party!

One stuffed hotel room as we sorted and packed!

We had to take some non-medicine stuff to pass out ;) 

I think we had 6 of these things.

Before we knew it we were at the airport ( in the Delta lounge thanks to Scarlet and Joel!) ready to go! I was bursting with excitement inside. I knew I would never sleep so I popped a Tylenol PM, watched a tv show, and drifted into a fairly nice airplane sleep. 

With the kind KLM crew who helped ensure we could each take 3 bags

Coming Back Home

I have been home from Kenya for almost 3 days now but it feels like my trip was a lifetime ago. I have a camera full of pictures to edit, stories to write down, and things to share but I find myself unable to do any of them without coming to tears. Why? Because I miss it. I miss being there so much already my heart aches. While this may sound crazy and you may not understand, Kenya is my second home. 

This medical mission was a blessing in my life. Two years ago I fell in love and wasn't sure if I would ever make it back. Than a phone call came one day at a time when I was down about my purpose and God's plan, leading me back to be His healing hand once again. This time it was harder to leave. This time I really got to know the people who walk amongst the red clay roads, spend all day with backs aching as they tend to their crops, who carry jugs of water ( muddy water) for miles back home, and who have the brightest eyes and biggest smiles you will ever see. This time people became like family to me. Relationships were built that will last a lifetime. This time I saw a glimpse of my purpose in life; to be God's healing hand in the villages surrounding Atemo. 

I became a nurse for many reasons. First, I felt called. Led by the Lord into this field. Second, I truly love to care for others. But I now know that there was something more. That back when I was 17 and debating with my Dad about my future, God was already stirring inside me feelings about being a nurse because He knew one day I would use these gifts, these talents, and His love to reach the people in Kenya. No matter where my nursing career takes me. No matter what area of the hospital I will work in. I will always serve in Kenya as well. It's my calling. And someway, somehow I know God will continue to lead me back there throughout my life.

I have so many stories to share and so many pictures to show. I promise I will get to them as many have been asking to see how our clinics went. In the meantime, pray for this reverse culture shock I am going through. I didn't realize what I funk I was in until Trav told me I had been down ever since I returned. The hardest part about being there was not having Trav with me. The hardest part about being home is that he can't possibly understand what I saw, what I experienced, or how I feel. It's frustrating for both of us as I want so badly for him to know how things were and he wants to be at the same place I am. And of course, I don't want to be down. Yet there is a massive Kenyan sized hole inside me and I now need to pray about how I can serve from here. 

The one picture I have edited I will share about. This little babe came into my exam room on the last day of clinic in the village of Dago. After taking him from his mom I snuggled him through my exams on the family.  I didn't want to let him go and as I gave him a final squeeze I told my translator I was going to put him in my suitcase and take him home with me. I wasn't expecting the response I got. The mom looked at me and said, "Yes, please." After they left the room I sat down in slight shock. How could a mother be so quick to give her child to a mazungo? Ruth, my translator, filled me in on the life of these women. They work all day to tend to the crops, laundry, children, you name it while the men head into town, taking with them the crops that should be saved in case the family needs to trade for something and spend it on drinking and who knows what else. The women are left with the labor, often finding that they can't come up with enough food everyday to feed their whole family. Their families that are so large because they are forbidden to use any form of birth control. The men will not allow it so these 27 year old moms have 6 children and the burden of not being able to provide for them. On top of that many take on family member's children when the parents die of  AIDS and other diseases. So when she heard my comment to her it meant her child could finally be cared for in the way he needed. My heart broke.

Another prayer request is for next fall. I have been asked to come back. But this time, Trav will come too. As we pray over this we know that if it is in His plan for us to work side by side serving Him in Kenya things such as timing, funding for the trip, time off of work will fall into place. I am already excited at the possibility of serving with my husband and introducing him to a place I call home.