Dan's visit to the OR

Dan here….

Today started out just like any other day.  We got up, went to Bible study, and then started work for the day.  Kristen mentioned on the way to Bible study that another short-termer here asked if she could see Kristen do a C-section today.  We have mentioned from time to time that I should go up to the hospital to watch a C-section but the timing just hasn’t worked out up to this point.  Today was the day!  We got some male scrubs for me to wear from another doctor here and before lunch I saw Kristen do a C-section and welcome 2 healthy twin baby boys into the world.  It was the first time I got to see Kristen work, the first C-section I have ever seen, the first baby I have ever seen born, and the first time in an operating room!  It was a great experience.  It is nice to see my talented wife at work using the gifts that God has given her. 

Getting Ready for the OR

Baby 1 of 2

Almost finished

Moments of Joy

Kristen with some of the hospital staff outside of Maternity Ward

Kristen here…

Not everything here at Kapsowar Hospital has been smooth sailing.  I have lost both moms and babies.  There have been times where we have been out of desperately needed medications.  Equipment has failed.  At times the social struggles of working with some in truly desperate situations seem insurmountable.  However, there are also moments of joy.  These moments come with hope and encouragement. They are priceless in a world where death often is the expectation and life is a gifted miracle. These are the moments that help push me forward – gifts from the Lord when endless tragedy tugs at my heart. 

The last couple of weeks have given me several of such moments.  I smile each time I think about the patients involved.  I can’t help it.  One of these moments presented itself when a patient that I had been following came to see me in clinic because she felt like something “just wasn’t right.” When a pregnant mother says that to me the alarms start to sound in my head.  More often than not the mom is right.  They just know and then it becomes my job to figure out what is wrong.  This patient was of particular concern because she had no living children, but 8 miscarriages haunted her past.  This was the first time she had carried a pregnancy into the third trimester.  This was the first time she had the chance at having a healthy baby.  I held my breath as I scanned her baby with the ultrasound.  Still alive, breech and low on amniotic fluid, but we hadn’t lost the child yet.  With two weeks to go until her due date I turned to the mother and told her that today we were going to have a birthday party.  At first she looked at me in disbelief and then the tears started to flow.  Tears of joy, tears of surprise, tears of fear.  The long awaited day had come, but she had already experienced so much loss. Would her dream of having a baby actually be realized today?  I prepared her for a c-section and walked with her up to the OR that afternoon.  A beautiful baby boy! Watching this new mom during her subsequent days in the hospital made my heart soar.  The pride and amazement she had over her newborn baby was evident.  What an incredible thing to be a part of, what a privilege to watch as a miracle unfolded before me.

Another patient presented a few days later.  She was young, she was anxious and well into her third trimester.  Every little twinge of pain and fetal movement bothered her.  I probed deeper into her story and realized that she had been pregnant once before.  She had gone into labor thinking she would bring home a child only to deliver a stillborn baby.  One of a mother’s worst fears.  The image of that limp, lifeless body that you have grown and nurtured for nine months doesn’t ever leave a woman’s mind.  Horrifying. No wonder she was nervous.  I kept her in the hospital for several days, she was too anxious to go home, but she wasn’t really in labor yet.  Several times she begged myself and the hospital staff to just take her for a c-section.  Lots of reassurance and monitoring was given.  It wasn’t time yet.  This baby was doing well.  Suddenly one night her body decided it was time.  Labor came with a vengeance and before the evening was over a new life was brought into this world!  Two days later I laughed as I watched this new mother literally skip out of the maternity ward once she was discharged with her new little one bundled up in her arms.  You would have thought that she had won the lottery instead of just recovering from giving birth.

Some of the nurses in the NICU

The last patient story I want to share is one of joy and ongoing prayer.  Some of you might have seen the facebook post we shared a few days ago regarding a mother with an obstetrical history more brutal than anyone should have to bear.  This patient comes from a really poor community and literally has nothing and no family to care for her.  She came to the hospital desperately seeking help and was very upfront with us that she could not pay for our services – even willing to walk away from help because the cost was too great.  I am struck by her honesty and the personal responsibility she feels for taking care of her own debts – not always a quality found here.  She came for help because her past holds a graveyard of 7 children.  She had delivered 2 that had died shortly after birth and 5 others she delivered in her third trimester only to realize they had died before they could ever take their first breath.  Devastating for any woman.  This patient was now in her third trimester again, a time that should hold much joy and preparation for an expecting mother.  This patient, however, had been taught by history that this was the time most greatly to fear.  After giving the mother some medication and monitoring the baby for several days we began to see signs that we were losing the battle for this pregnancy.  Much prayer was put into the decision to deliver this patient because the baby was small and not all premature babies do very well here.  There was deep risk involved no matter what decision was made.  We proceeded to the operating room and the cry of that first breath of life never sounded so good.  The mother was in disbelief.  The baby was taken to our NICU due to the prematurity and the mother was taken to the maternity ward after surgery to recover.  Over the next few days the mom visited the baby periodically, but it was very hard to read any expression on her face.  What was running through her head?  Finally, three days after delivery. The day that marked the longest she had ever had a child live I was sitting next to her on her bed going over her care and discussing her baby.  The mom indicated to me that she was scared.  She was worried because the baby was on oxygen by nasal cannula.  What did this mean? Was this one going to die too?  Quickly, I gave reassurance.  The baby was actually doing very well, in fact better than expected.  The baby was only on a small amount of oxygen and would soon not need even that.  This stoic mother’s eyes filled with tears.  The stress, relief, anxiety of the last 7 months was finally coming out.  She actually had a baby that wasn’t dying on her.  It was an incredible moment to be a part of.  I put my arm around this patient as my eyes welled with tears too.  I was watching a miracle.  The subsequent days for this little one have been up and down.  Fighting rapid weight loss and even a fever on one occasion have kept all of us praying for this mother and her baby.  Overall, things are still heading in a positive direction.  Now on day 5 of life I am watching this mother spend time in the NICU caring for the baby, meticulously washing her hands and drying them under a heating light before touching her baby, learning to do feedings through a nasal tube and bonding with the only child she has ever gotten to hold.  Though the story isn’t over yet, it has been one that has given me incredible joy to see.  

The mural painted in the office where I see patients.

We are legal!

Kristen here...

This last weekend Dan and I, along with the McCurry's (another missionary family here at Kapsowar) made our way down to Nairobi to get fingerprinted for our work permits/visas that will allow us to be here for the long term.  This was definitely an adventure.  We left at 4am to make the drive.  The first hour and a half was on a really rocky dirt road.  It was dark out and the dust cloud created by the car in front of us resembled those days when I would try to drive to work back home through a raging snow storm.  The only difference was that we weren't driving on ice.

We then got to the paved road and I thought things would get better.  Wow, driving sure is different here.  The two lane highway that runs through most of Kenya forces people to spend most of the trip passing big trucks and playing a game of chicken with oncoming traffic.  Every lane is a passing lane no matter what the lines painted on the tarmack tell you and as a courtesy you try not to run the motorcyclists that are coming towards you off the road as you drive in their lane.   Every little village you go through has a series of speed bumps, most of which are not marked.  We definitely flew over a few of those! Then you have to dodge people as they cross the road in front of you and try not to run over their feet as they swarm your car trying to sell you things in those moments you slow down for the speed bumps in their town.  Missing the pot holes isn't easy either especially when you are trying to watch out for the cows, sheep and zebra that are standing in the road and monitor what the guy coming towards you is doing and if he is going to get back in his lane on time for you to miss hitting him.  Whew.....driving is definitely not for the faint of heart.  8 hours of this definitely tests what you are made of.

When we made it to Nairobi there are a whole different set of traffic rules.  You make up the lanes as you go and if you don't have a lane sometimes you just drive on the sidewalk. Red lights don't mean a thing and whoever is the most aggressive driver wins.  It is by God's grace we got to our guest house without any issues.  I took a shower that night to get all of the dust and grit off of me.  I cannot tell you how wonderful that was.  I had all the hot water I wanted, with enough water pressure to shave my legs and actually get all the soap off and I didn't even get electrocuted once!  Those small things make all the difference in your bathing experience.  :-)

The next day we went to the immigration office to do our fingerprinting.  This process made the DMV look like the most organized and efficient system known to government.  At one point they told us they needed us to supply them passport photos.  Where in the world are we going to get those?  Apparently this is not an uncommonly asked question, because right on the street corner someone had set up a little side business providing just this service.

Ashley McCurry getting her passport picture taken on the streets of Nairobi.

We arrived at the immigration office at 9am and by 4pm the fingerprints were done. We are now legal alien residents of Kenya!  I am just so thankful that we were able to get everything done in one day.  During the middle of the day while we were waiting for the paperwork to be completed some friends of ours took us out to see the nearby sights of Nairobi. This adventure included a stop at the local Cold Stone Creamery.  Yes, Cold Stone has made it to Kenya!  Ice cream never tasted so good!  We also climbed to the top of the tallest building in Nairobi and got to view the city from the roof top.  It was amazing to me how big this city is and how there is so much of it that I didn't know existed.

Bird's eye view of the heart of Nairobi. No two buildings look alike.

We were able to do some shopping in Nairobi.  Small things like discovering a tube of Crest toothpaste in the grocery store or Mac N Cheese out of a box or a can of sweetened condensed milk totally made the shopping trip fun. I know it seems silly, but it almost feels like Christmas when you discover some of these familiar items.  I also discovered a store with contact solution.  Unfortunately, the going price was $30 US dollars a bottle.  Hmmmm....I am going to have to figure out some other way to get this.

Overall the trip was fun, successful in that we accomplished our paperwork goals and a good time to spend time with friends away from the hospital.  It was nice to have a little time away and to enjoy a few tastes from home like Cold Stone ice cream and Dominos pizza.  There aren't any options for eating out in Kapsowar so this was a huge treat.  I discovered that my husband is a driving ninja and has mastered driving on the left side of the road from the left side of the car (we drive on the British system here).  I am so thankful for him, because I don't think I could work up the nerve to make the drive myself.  The adventures just never stop.