Inspiration

Sometimes, I need a little inspiration in my work, home life, and faith. This month, I want to share two sources of inspiration and encouragement. Enjoy!

The first is an article written by Dr. Eric McLaughlin, a graduate of the Post-Residency Program (World Medical Mission) and a physician at Kibuye Hope Hospital in Burundi - he and his wife Rachel are also our team leaders through Serge. He's also written an excellent book, Promises In the Dark: Walking with Those in Need Without Losing Heart. 

https://www.christianitytoday.com/ct/2023/november/i-stumbled-in-steps-of-good-samaritan.html?utm_medium=widgetsocial

The second is a new video from our local videographer and teammate, Regan, featuring our two plastic surgeons who have been doing facial reconstruction surgery for patients from outside of Kenya with limited access to healthcare and no access to specialized surgeons. These patients stay in Kapsowar for months at a time to have multistage surgeries performed.

(I'm not very familiar with Vimeo and can't figure out how to embed the video, so you'll just have to follow the link or search for "Becoming Whole: Facial Reconstructive Surgery at Kapsowar Mission Hospital" on the Vimeo website. https://vimeo.com/932169521 )

Fat Tuesday

This week, we celebrated our FIFTH "Fat Tuesday" in Kapsowar. We started with pancakes in 2020, quickly realized that pancakes are entirely too time consuming to make, require a lot of cleanup, and are difficult to eat outside (as necessitated by Covid in 2021), so we switched to doughnuts and haven't looked back! 

The idea of Fat Tuesday (Mardi Gras, in French) was - traditionally - to use up the last of the fat and sugar stores before starting a Lenten fast. Doughnuts definitely meet that criteria! (I'm not going to write about the WHY of a Lenten fast here, but I did find a really nice article about Christian fasting at this blog: https://gravitycommons.com/how-to-fast-for-lent/  - I'm not endorsing the whole website, I don't know anything about their organization, but I really liked their explanations of why and how to fast.)

Fat Tuesday gives us an opportunity to meet with our community, talk about our experiences with Lent and Easter (some of us grew up in very "high church" backgrounds, others grew up very evangelical and have never been exposed to the church or "liturgical" calendar, many of us fall somewhere in the middle), and discuss why or how or if it is important to prepare for Holy Week and Easter. 

Here are some photos of Fat Tuesday, and Dominic's favorite doughnut recipe, inspired by reading Farmer Boy and adapted from a recipe we found online:

African Twisted Doughnuts (adapted from www.preciouscore.com)

Makes: 24 doughnuts

12 oz evaporated milk (see recipe)

2-1/2 tsp active dry yeast

3 T sugar

3 T melted butter

1 tsp salt

1 egg

4 c all-purpose flour

Cinnamon sugar, powdered sugar, or glaze of your choice

1. Make evaporated milk: Boil 3-1/4 cups whole milk or shelf milk until it is reduced to 1-1/2 cups (12 oz) OR warm up 12 oz of evaporated milk (from a can) 

2. Let evaporated milk cool until it is just warm to touch. Stir in yeast, let rest for 5 minutes

3. Whisk in sugar, butter, salt and egg

4. Stir in flour with wooden spoon, then knead dough for 5-7 minutes, adding flour as needed

5. Cover and let rise for 1 hour or until doubled in size

6. Roll dough out into a rectangle, then cut into 24 strips (I do mine as 2x12)

7. Create twists by rolling into "snakes" with hands moving in opposite directions. Keep twisting the dough until it twists up, then pinch off the ends (this takes a little practice the first time but it gets easier!)

8. Fry in oil at approximately 350 degrees (I just get the oil hot until it forms bubbles around a small piece of dough when dropped in), turning after about 1-2 minutes

9. Roll in cinnamon sugar immediately, or sprinkle with powdered sugar after cooled, or try a glaze

Photo Dump!

 In no particular order, without explanation or excuse - photos from the last 6 weeks.

Chameleon hunting is a popular sport in our neighborhood. As far as I know, all the moms have a same-day capture and release policy. Chameleons don't thrive in captivity.

Heading to school with Dad and Nala

We love guest teachers, especially those with special skills!

Heading to Nairobi for passport renewal meant a great opportunity to check out some new restaurants! Dominic chose (no surprise) a chocolate croissant and vanilla milkshake for lunch. What was a surprise was the size of the croissant!

Some mornings can be a little chilly in Kapsowar.

First day of Grade 4! Finally learning some keyboarding!

Olie bollen for New Years Day

Obviously I'm not a food blogger - We made Indian food for Christmas lunch

No, this is not a flashback - Christmas Eve Potluck was cancelled last-minute due to a Covid outbreak at our station! We collected and redistributed food from the unaffected households, and then had an outdoor meal with what remained with a couple of our neighbors

Kapsowar's first (I think) Christmas Cookie Exchange was a great success! So many yummy treats to enjoy!

Christmas in Kapsowar

Merry Christmas from Kim, Kris, Dominic and Nala!

Two years ago, I made a promise that someday I would write about Christmas 2021. From a professional perspective, I had endured more difficult periods in Kapsowar than those 48 hours starting at about 7pm on Dec 23. But that Christmas, and the tragedies I bore witness to in the lives of my friends here, are a poignant example of why being a rural doctor - in ANY community, in ANY country - can be so heartbreaking. And why being an OB/Gyn - in ANY community, in ANY country - is a profound privilege, as we walk with families during their moments of greatest joy and deepest sorrow.

There are about 200 employees at AIC Kapsowar Hospital. If I make a conservative estimate, in the 4 years I've been here, I've probably been involved in caring for about 10% of these employees or their spouses during their pregnancies. There are 3 employees who I've cared for during 2 pregnancies each - and two of those delivered their babies on Dec 25 and Dec 26, 2021.

I met the first employee's wife when she presented with a non-OB concern VERY early in her pregnancy. I was consulted to comment on the potential risks of treatment for her non-pregnancy related condition, and found out that she had numerous reasons for a VERY high risk pregnancy- including prior stillbirth, a prior very preterm delivery due to a serious pregnancy complication, and two significant medical conditions despite appearing to be a very healthy young woman. In North America, she would have been extensively worked up by a High-Risk OB doctor before pregnancy, and been followed weekly or every other week until a likely early delivery.

However, our options for Rachel's pregnancy were limited (not her real name, of course). She was returning to her job about 8 hrs away, where she would be living for most of her pregnancy. Her medical conditions required close monitoring as they would likely worsen during pregnancy, but she wasn't able to perform the monitoring from home due to lack of proper testing supplies/equipment. Ultimately the couple decided to continue antenatal care with a specialist close to her work, but running his recommendations through me before implementing them. Things were going okay- she saw me for a growth ultrasound a checkup around 20 weeks, and there were no signs of poor health in mom or baby. But we had quite a while to go before this baby would be "viable" - have any chance to survive outside the womb. In Kapsowar,  "viability" is 28 weeks or 1kg, but babies born that early have a LONG fight ahead of them.

Fast forward to the week before Christmas. Aaron (not his real name), still working in Kapsowar, told me that Rachel had had an ultrasound at the specialist's office because the baby wasn't moving well. The specialist said the baby was smaller than expected. No big deal, we'll just change your due date, he told Rachel. I was speechless. We had the best possible dating for Rachel's pregnancy - a first trimester ultrasound that agreed with her last menstrual period. Rachel had at least 5 good reasons for her baby to be small or "growth-restricted," all of which were reasons for significant concern and further testing, NOT reassurance and changing her due date. I told Aaron that I was  worried, and that I recommended that Rachel either find a doctor in her area who could perform proper antenatal testing, or return to Kapsowar as soon as possible so that I could assess the baby myself.

The next day -the night before Christmas Eve - our family was at home watching a Christmas movie in the evening. I got a call from Aaron. Rachel had returned to the specialist- she had not felt the baby move for over 24 hours. The specialist was gone - traveling for Christmas holidays - but the person filling in for him had performed another ultrasound and diagnosed stillbirth, now Rachel's second. He recommended emergency c-section to remove the baby, because Rachel had had a c-section for delivery of their only living child. I asked some follow-up questions- was Rachel okay? Were her blood pressures normal? Was there any reason why she couldn't travel to Kapsowar? And then recommended that she leave her local hospital and travel here so that I could safely induce her labor and spare her a major surgery if possible. Aaron agreed.

All through Christmas Eve, Aaron and I waited for Rachel to arrive via public transport. Meanwhile at home, I tried to carry on with our Advent celebrations - but awaiting the birth of the Christ child, and anticipating the birth of my friend's demised baby, produced a sobering contrast of emotions. When Rachel finally arrived, I confirmed her diagnosis, explained the induction process to the couple, and prayed with them for a quick and uncomplicated delivery. Through that Christmas Eve night, Rachel labored, knowing that this Christmas baby wouldn't be the gift she has waited for.

On Christmas morning, Rachel was able to deliver safely and quickly, and I was even able to be there for the delivery (I don't often make it for normal deliveries since all our moms are unmedicated and can't wait for the doctor!). I went home, mourning but thankful that the worst part of the day was now over, and ready to celebrate Christmas.

A few hours later I got a call from maternity. Sharon - another employee at the hospital, pregnant with her first child after years of trying, and Aaron's next-door neighbour - had just arrived at maternity. She hadn't felt her 34-week baby move in 24 hrs. The nurse had listened, and listened, and listened for the baby's heartbeat, but couldn't locate it. Could I come in and do an ultrasound to find the heartbeat for them? Sharon was starting to get anxious.

I grabbed my things and walked in to the hospital with a sinking feeling. My nurses almost NEVER fail to find a heartbeat. But maybe these were inexperienced nurses, on call on Christmas Day. Maybe the baby was in a funny position, making it difficult to find the heartbeat. Maybe it was just fetal distress - maybe the heartbeat was low, but we could still get the baby out in time with an emergency c-section. Lots of maybes, and prayers, and pleading during that 5 minute walk to the hospital - but the ultrasound was clear. Sharon's baby had also died.

Two years later. Did it really take me that much time to recover emotionally from that Christmas, to tell their stories? Well, yes and no. This Christmas, Aaron and Rachel will celebrate Christmas with their infant twins, born last fall after a VERY closely monitored pregnancy (between me and a real High Risk Pregnancy Specialist in Eldoret). Sharon and her husband will celebrate their daughter's first Christmas - after receiving a diagnosis of diabetes and starting treatment, Sharon was able to carry her pregnancy to term and went home with her healthy baby in September. We've all talked about sadness that we experienced that Christmas, and that we remember every holiday season, and about what a blessing it is to have something (someone) to celebrate this year. And those tiny someones give me the courage to share their families' stories.

BUT. Sharing their stories is something I also do with caution. There are a lot of heartbreaking and amazing and unbelievable stories to tell in our community and in this area of the world, and I want to tell those stories with the gravity and respect they deserve, because these are real people, my real friends and neighbors, not statistics or tragic characters designed to stir up sympathy and donations. We're really excited to have a videographer on our team who is helping us to navigate that balance. Here is a recent short video that she put together about the hospital. We hope this video helps explain why we are here and why we do what we do!

If you are interested in donating to the "Needy Patient Fund," please follow this link to donate through African Mission Healthcare, an organization who supports our hospital in a variety of ways. 

Giving Every Day

Based on the number of emails in my inbox yesterday, it looks like I definitely missed out on a popular day to communicate with supporters, by NOT sending out a Giving Tuesday communication! It did remind me about this blog post that I've been meaning to write, though.

At last count, our family has 90 households and six church congregations financially supporting our work in Kapsowar. But what does "support" mean? Where does that money go? All of our support comes through Serge (www.serge.org) and the Great Commission Fund (www.gcfcanada.com). Every month, money is distributed from our account at Serge to pay our salaries, social security, health insurance, retirement contributions, and child education expenses. Other monthly expenses that are covered include our rent and utilities, salary for our house helper, and administrative fees for Serge, which include things like Member Care (the team of people that make sure we're staying physically, emotionally, and spiritually healthy while we're overseas), administration of our account and website, education support, help with other details of living abroad. We also submit receipts for one-time expenses. These can include things like travel to and from Kenya, conferences that we attend, support we provide to co-workers, patients, or other local community people (for example, medical treatments or counseling expenses), supplies for our places of work, or tea and snacks for our weekly Bible study. Our visa expenses, and my medical licenses (US and Kenyan) and continuing medical education fees are also covered. Pretty much anything that is associated with our ministry (work at the hospital or theology school) or an additional expense that comes with living abroad is covered, in addition to costs associated with travel to raise funds or visit supporters. 

That seems like a pretty comprehensive list, so you might wonder what our support-raised funds DON'T cover! Well, on a daily basis, we pay for our own food and any recreational interests. When we travel for fun or vacation, we pay for those expenses too. We own our own car here in Kapsowar, so we pay any vehicle-related expenses (although if we're traveling for a ministry-related reason, we would be able to claim that mileage). If we're making major improvements to our house because of where we live (for example, repairing our solar power panels because our grid power is unreliable) we get reimbursed for that, but if we're just buying something for our home because we like it - like upgrading our bed and mosquito net a few months ago - we pay for that kind of stuff. And of course clothes, books, household supplies, everyday living type of stuff we pay for ourselves. 

Thanks so much to those of you who generously give to support our work here in Kenya. If you are interested in knowing more about that work, please email me or leave a note in the comments, and I'll be happy to add you to our newsletters!