Reality Check

Every 4-6 weeks, we have a zoom meeting with our friends at the Post-Residency Program (PRP) and the other Post-Residents working in East Africa.* Like all organizations, I think the PRP realized that we're not going to be able to see each other in person as often as we used to, so these regular zoom meetings are a great chance to check in, give updates, provide encouragement and share tips, and remind each-other that we are part of a bigger team. We had one such meeting earlier this week, and I'll be honest, it was a struggle. Having to summarize the condition and concerns of your hospital, your family, and your community in a 5-minute update can be difficult. Especially when your updates become consistently more bleak from month to month. 

So, in the interest of being honest and keeping you in the loop, read on for the reality on the ground in Kapsowar. But before you do, consider reading this article by someone who actually has long-term experience in the field of medical missions and can speak more clearly to the challenges in medical missions in the age of COVID. 

https://www.medicalmissions.com/resources/32921/what-is-the-future-of-medical-missions 

Now for the situation in Kapsowar. In the interest of not sugar-coating it for this blog, I've take excerpts of an email I recently wrote to a mission organization, removing details to protect the privacy of our colleagues: 

When our family arrived, there were 2 graduates of the Post-Residency Program serving in Kapsowar as long-termers (11 years in Kapsowar and 6 years respectively). They were both family medicine docs who were trained to do OB care also. Their families have both relocated back to the US. One of those families would love to return to Kapsowar, but the reason they left is that one of their family members is suffering from long-COVID syndrome and currently cannot live at high elevation (we're about 8000 ft here). 

The other physicians here include a plastic surgeon and his wife (US-based). They are a rock in the missionary community here, but also do a lot of international travel to places even less-served than Kenya. When they are out of town, I am the longest-serving physician in Kapsowar. We also have 2 Kenyan surgeons. One arrived 18 months ago and the other, about 2 months ago, when our longest serving Kenyan surgeon left for another mission hospital. 

A new PRP family medicine doc started here in February 2021. He is not trained for OB care and is busy directing our year-old family medicine residency program and helping manage the housing/station with his wife, who also homeschools their 3 kids. They are extremely busy and I think it's fair to say, overworked. We have a dentist, who is also in the PRP and has been here almost a year. 

SO, in summary - in the course of about a year we went from a community with multiple different specialties, lots of experience, and tons of knowledge, to a community of brand new residency graduates, brand new to Kapsowar, (many brand new to Kenya) and many different responsibilities that we weren't anticipating like running a residency program or being responsible for housing. We have two more short-termers scheduled to come this year, and then we're not sure what help will come and from where. Welcome to medical missions, right? 

Despite all the challenges here, our family loves Kapsowar. We know that we'll find challenges anywhere, but there are a lot of things that excite us about this community and about our opportunities here. Kristopher teaches theology at the seminary located immediately adjacent to our hospital, and has really enjoyed building relationships with his students, most of whom are already pastors in the Africa Inland Church but have no or limited formal training. I am crazy busy at work but also have opportunities to train residents and hope to be able to start some community outreach programs in the future. Dominic has a ton of freedom to explore, play, and just love being a kid within our beautiful community. Ideally, if we can figure out a solution to educating Dominic, we would be happy to stay in Kapsowar and continue our work here.

We also know that we're not the only people undergoing challenges during the COVID pandemic. So many peoples' jobs and careers have been interrupted or lost, and so many others have lost their lives or been affected, possibly irreversibly, by the disease. I feel especially for those healthcare workers in the US and other developed countries where vaccines are readily available. The work of caring for critically-ill people who had an opportunity to vaccinate but didn't, and the trauma of watching resources diverted to a now-avoidable pandemic, is doubly-traumatizing and I truthfully don't know if I could continue to work in that situation. 

I'm not really sure how to wrap us this post...if you've stuck with me this far, all I can say is (1) thank you for caring, and (2) please continue to pray for us, and so many other workers who are trying to stick it out in difficult places, whether that's an ICU in Mississippi, doing disaster response in Haiti, responding to violence, war, and famine worldwide, or in a tiny hospital in a small corner of Kenya.

 

*For those of you who are unfamiliar, the Post-Residency Program is a program run by World Medical Mission, the medical arm of Samaritan's Purse. Physicians who have completed their residency training recently (about 5 years or less prior to applying) and are interested in long-term medical missions are hired into the Post-Residency Program and then sent to work in a mission hospital, ideally under the supervision of a mentor within their field. We are fully trained physicians who could be working at any hospital in the US - but we've chosen to work in low and middle income countries instead, where access to medical care or specialty care might be a problem. The great thing about the PRP is that they provide a salary, health insurance, language training, and an amazing amount of support to their physicians, so we don't have to fund-raise for those things...but only for a limited time (about 2 years). During the last year of our time with them, we need to start transitioning to another organization or "sending agency" that can keep us in the field long-term.

What will you do on your "S-Days"?

Dominic attended preschool for about 12 weeks in Nairobi, where he had two lovely women caring for and teaching him: Teacher Dorinah and Teacher Esther. He learned many important lessons, most of which had nothing to do with academics. One song he learned has stuck with him - a little diddy to remember the days of the week.

Sunday, Monday, Tuesday, Wednesday,

Thursday, Friday, Saturday.

Seven days are in a week,

What will you do on your "S-Days"?

Dominic saying goodbye to Teacher Esther - obviously pre-COVID!

Our "S-Days" have varied a lot in the past year. During the peaks of COVID, while our hospital was not yet receiving volunteers or visitors and the country was under lockdown, our weekends were pretty quiet. Being busy at the hospital, and being a pretty strong introvert, I have to say that I didn't mind that too much. I had lots of time to cook, bake, knit sweaters (four in the last 12 months) and prepare Dominic's homeschool lessons. Kris liked to use the weekends to workout, read, chop firewood, and play with Dominic. For Dominic, of course, every day is pretty much a weekend - the only difference is no school in the morning and maybe a chance to watch a movie or play a board game at night. We have decided not to take Dominic to in-person worship services on Sundays as we know COVID is still making its way around our community and we don't know which variant it is, so we have been participating virtually in worship services from Vancouver First CRC, where Kris and I attended church over a decade ago!

I had several opportunities to attempt pie-baking during lockdown. So happy to have rhubarb in Kapsowar!

Now that travel restrictions have eased somewhat, and we have more visitors coming in and out of Kapsowar (and fewer "permanent" households to welcome them), our weekends look different. More socializing, coordinating trips to different hikes or tourist attractions, figuring out who is coming and going in the week ahead, worship services at station, campfires, and recently, shopping trips to try to furnish our "new" (previously unfurnished) house. I may not be the biggest fan of Ikea, but I can tell you that after two months without a dining table, even Ikea is starting to sound pretty good! 

Enjoying a meal at a new restaurant in Eldoret with our new friend Anna

Dominic after a long hike

An outdoor potluck/worship service. I'll never figure out how the four little boys got chairs while the grown-ups are sitting on the ground!

After nearly 12 months of routine, it has been nice to see some new (and old - I mean familiar!) faces, to experience Kenya through their eyes, and to be encouraged by them. Now that the North American summer is drawing to a close, it looks like our weekends will be settling back into the old routine for a while. During those quiet times, we're thankful for memories with new friends, and looking forward to future visits!