Going somewhere?

Over the last month we have been busy with travel *within* Kenya. Due to Google maps and the internet, we do have greater freedom and confidence to travel around the country. Here's a glimpse at the methods we have used to travel in Kenya over the last few years (and some options we have NOT opted for in our personal journeys). 

Planes:
Our preferred airline is JamboJet simply because they are the most consistent airline at Eldoret Airport. We can get direct flights to Kisumu, Mombasa, and of course Nairobi from Eldoret. As in North America, air travel is the safest and most expensive way to travel. The dangers of the road in Kenya make air travel MUCH more appealing here - and also too expensive for most of our neighbors.

Dominic was 4 years old the first time we flew to Eldoret

Nala arrived to Eldoret in this tiny private plane

Trains:
The SGR (Standard Gauge Railway) connects Mombasa and Nairobi, and passes straight through Tsavo National Park, which means you get a view of Mt. Kilimanjaro AND lots of animals as you travel.
The journey itself takes about 5.5 hours and since the train stations are a little far from the city on both sides, it's really a full day of traveling. It's fun, safe and very affordable as long as you have the time for it!

Capturing photos of the wildlife was difficult, so we just took pictures of each other

Automobiles:

Personal vehicles: Well beyond the resources most rural Kenyans is a private vehicle. Having a person vehicle gives us independence to get out of town when we're able on our own schedule, but also comes with some pitfalls, including run ins with law enforcement, high risk of accidents and getting lost in areas where Google maps is misleading.

Hitting the road for our first trip in our "new" car back in November 2020

We have to keep a keen eye out for wildlife on the road!

Taxi and Uber: most ex-patriates we know have phone numbers saved for local drivers who know the area well and are trusted.
Tuk tuks: we haven't personally used a tuktuk - they are more common in the flat lands like the coast. They look like a tricycle but enclosed.
Matatu (buses/commuter vans): These are a very common method of travel and are probably safer than motorbikes, but still have a LOT of accidents.
Motorbikes (piki piki or bota): This is the most affordable and flexible AND DANGEROUS mode of transportation that we encounter in Africa. It seems that nearly everyone who uses a motorbike has been in an accident (minor or major) at some point.

Boats: We've been on three boats in Kenya - a canoe at Crescent Island, a ferry in Mombasa, and a glass bottom boat in Diani.

Bikes: Kris and Dominic both have bikes that they ride around our station. Bikes are probably more common in other areas of Kenya, but due to the very hilly terrain around Kapsowar, they are not a common method of transportation here.

Kris bought Dominic's first bike at this used bike "shop" in Nairobi during language school

"God gave you two good legs..." As I commonly remind Dominic, we have a great method of transportation in our legs! Traveling around Kenya you will find that most people are outside most of the time, working in their fields or gardens, walking from one place to another, cooking or preparing food, getting water, conducting their business (taking advantage of the free lighting provided by the sun rather than putting their business inside and then artificially lighting it), or relaxing - watching their surroundings or socializing with neighbors rather than turning on a television, videogame, or computer. Many places are inaccessible by vehicle or bicycle.

Walking to see giraffes at Kruger farm

Not ready to move to the developing world? Consider a short-term trip.

I had a chance to write some reflections for an organization / website called MedicalMissions.com about a year ago. They were planning an online seminar and publishing a series of short reflections about short-term involvement in missions. This reflection is really geared toward people in medicine, but I think it can apply to ANYONE visiting ANYWHERE new for ANY purpose. If you want to read more from other long-term workers or other people who have participated in short-term trips, there are tons of resources on the MedicalMissions.com website. I have also attended their Global Missions Health Conference (once, a long time ago) which is a great conference to learn more about opportunities to serve (medical and otherwise) around the world! Before arriving in Kenya as a mid-term medical missionary myself, my experience with short-term medical missions (and missionaries) was limited. In one mission trip, I had been on a one-day pharmacy outreach to diagnose and treat acute and chronic illnesses with a “gift” of seven days’ worth of medication; I had also watched specialists performing life-changing surgeries during a one-week outreach to patients in an extremely rural setting where they would otherwise have never had access to those procedures. For better or worse, I had intentionally decided not to participate in short-term medical missions during my residency, so that I could focus on developing my knowledge and skills before entering long-term service. So, in my first three months in Kenya, as I struggled to get my bearings in a new country/culture/language/hospital, I viewed short-terms in a variety of ways: as important encouragers and sustainers, as liabilities, as time-givers and time-consumers, as free babysitters, as potential future partners or financial supporters, and as the important final link in the all- important Hot Wheels and chocolate chip supply chain. Then, abruptly, there were no more short-termers. In the initial phases of the COVID pandemic, as a new physician, I have to be totally honest – the break from short-termers gave me time to really establish my footing and get my focus within my practice. But after a few months, the path between my front door and the Maternity Ward started to lose its luster and became tiring. A few months later, our long-term colleagues began to leave, for a variety of primarily COVID-related reasons, and the incoming volunteers were minimal. Within 18 months of the start of the pandemic, I became the second-longest serving clinical physician (Kenyan or foreign) at our hospital. Being without short-term volunteers for so long served to highlight the importance, as well as some of the challenges, of integrating short-termers into a long-term medical missions strategy. Due to COVID, I can say that my experience with short-term medical missions remains limited. But thanks to some absolutely amazing short-term volunteers, I can tell you some characteristics that stood out and made for really positive experiences. - Come for as long as you can. Remember that you when you arrive you will be tackling jet-lag, absorbing a ton of new information, and that orienting you takes a large investment in time and energy. The longer you stay, the better the return on investment – for you and the hospital. - If you’ve been somewhere already, return to the same place. You’ll know the hospital, workflow, records system – and more importantly, the people and eventually even the patients. - If you’re coming to serve, make yourself a servant. You may be asked to perform ACLS and save someone’s life in the emergency department. More realistically, you may be asked to cover outpatient clinic for a couple of hours while I catch up on homeschool with my kid. Both of those scenarios are a huge help; only one makes a good story. So ask yourself, are you coming to serve, or to collect stories? - Be gracious with your host-physicians. When we moved to Kenya, we were told to resist the urge to suggest changes for 6 months. Instead, our sending agency advised us to observe, take note, and try to understand the rationale behind things that we didn’t like or understand. Well- meaning questions or off-handed suggestions from a short-termer can put a mid- or long-termer on the defensive, especially early in their career when they too are trying to figure out the system in which they work. If you have genuine concerns or recommendations, save the comments for a time when you can have a serious conversation – not between outpatient visits or on morning rounds. - Be honest with yourself and your host about your skills and comfort levels. We’ll find a way to use your talent, but knowing in advance helps us to put you in the right place to help our community.

Spot the Differences

Remember this game? Staple of kids' magazines, children's menus and activity sheets, you have to identify the subtle (or sometimes not-so-subtle) differences between two pictures. 

In some ways, it feels like our last four months in Kapsowar have been a game of "Spot the Differences." So much is the same - and yet we were warned, and have certainly found it to be true, that returning for our second "term" has felt very different than coming to Kapsowar for the first time. Here are some of the things that I (Kim) have experienced as a returning long-termer.

The Same:

- Our house: It has been comforting and just all-around nice to return to our home, our kitchen, our comfortable space. We loved visiting friends and family all over N America, and making Seattle our home base. But I also love my cookbooks and craft closet, we love our dog, our games, even our well-worn movie collection (Babe again, anyone?). 

- The work: with all it's challenges, I love my job. It is fun, rewarding, discouraging, and heartbreaking, sometimes all in one day. I wouldn't trade it for any other work - especially studying for a board exam, which is what I spent most of the late summer/fall of 2022 doing!

- The community: what keeps us in Kapsowar is the community - not only the wonderful Kenyans who we work with, but also our smaller Kenyan and N American community living together at the "station." Although most of the members of the community have changed since we arrived here in November 2019, the rhythms and feel of the community, thankfully, has not. We have enjoyed not only being back here, but also helping to welcome others into that community.

- Fat Tuesday! We hosted the 4th Annual Fat Tuesday celebration at our house earlier this week. I'm learning from my experience every year - this year I really simplified by making mostly baked donuts the night before (when I was not on call) and only frying Ollie Bolen (apple and plain)

Gathering for donuts near our avocado tree - another thing that stays the same is wonderful local (sometimes VERY local) produce

Last day before Lent indulgences

Growing kids can eat a LOT of fried (and baked) dough!

Some kids - and adults - were interested in the frying process

The Differences

- New community members: As we anticipated, we left Kapsowar in May with very few long-term community members, and when we came back in November, we were just at the beginning of a season of growth for the community. Dominic was the only N American kid when we left. Now he's one of 16, soon to be 17! It has been truly fun and encouraging to get to know all the new families. And there are still more to come! It has also been a challenge to be some of the community members who have been here the longest. We get a lot of questions, and don't always feel like we have great answers. 

- The responsibilities: Along with the expanding community is a heavier burden of community responsibilities. More decision need to be made, with more people weighing in on that decision-making process. Fortunately, there are also more shoulders to bear the load, and we are really thankful to be handing over some of our tasks to new people with more passion and energy than we have.

- The social opportunities: For us and for Dominic! So far, Dominic has been involved in a Christmas pageant, a play (the story of Esther), and a comedy night - Dominic read (and sang!) jokes out of his joke book before a campfire last Saturday

The tree fort in our front yard makes a great stage

- The climate and economy: On a negative note, Kenya has been hard-hit by drought, which is even effecting our normally very green area in the hills. Lately even the power grid has been effected, with scheduled power outages due to (we hear) lack of hydro-electric power. The economy has had a double-hit from poor crops, and fairing poorly in context of global economic hard times. Locally, people have been struggling to buy basics including food, medicine, and paying school fees. It hurts to see the people around us hurting, and it hurts to know that people in countries around us are in even more difficult conditions. 

We appreciate your support and prayers for our family as we navigate this second term, and for Kenya as we wait for the rains to return! Thanks for reading!

Enmity, and a New Years Resolution

Over the summer, I was composing an email regarding the elections that were happening in Kenya at the time, and I became quite exasperated because Gmail marked one of my words as mispelled. "Emnity." You know, the state of being an enemy of someone. A word that probably isn't used often in day to day conversation - although perhaps more commonly now than twenty years ago.

But, of course, the word isn't "emnity," it's enmity. And at thirty-something years old, with over 25 years of education under my belt, I had the opportunity to face the fact that I have been outright, objectively misreading and mispronouncing this word for my entire life.  

It was a silly, pretty insignificant little thing. Nonetheless it got me thinking about those beliefs, assumptions, opinions, worldviews that become so unquestionable to us. Things that are less objective than simply misspelling a word. Moving to another country and culture does a lot to expose those unquestioned beliefs and worldviews. So does coming back to your "birth" culture after living somewhere else for a while. Some of the things I've been wrestling with are, what does it mean to be blessed? What would Jesus say about individual rights? How can the church try to please God, not people (as Paul taught) but still show Christ's love in the world? Unfortunately Google can't give me the right answers to these questions, at least not as quickly and objectively as the correct spelling of enmity. 

The first part of August, we were in Michigan at a program called AlongSide. The best way I can describe it is an intensive support group, with a combination of lecture, small groups, and individual/couples counseling, all in a beautiful setting with time and space to start processing what we were learning. The program we attended was specifically designed for Christian healthcare workers and their families who had been serving overseas. We had a great experience, and I highly recommend the program (please contact me if you want to know more). My main takeaway from that time, the virtue that I want to try to practice as head into a new year and new season with our team in Kapsowar, is humility. Humility in the face of another culture that I don't understand. Humility in the face of a culture that I do understand, and sometimes don't agree with. Humility as we make decisions for our family, participate in decision making in Kapsowar, and participate in the life of the church. It's a scary thing, to put down in writing an aspiration to humility - it feels a little like telling someone you're trying to lose weight while you're in a buffet line, just opening oneself up to scritiny. 

Someone from the program presented this quote from Augustine. It's a little dense, but worth struggling through:

To [Jesus], my dear Dioscorus, I wish you to submit with complete devotion, and to construct no other way for yourself of grasping and holding the truth than the way constructed by Him who, as God, saw how faltering were our steps. This way is first humility, second humility, third humility, and however often you should ask me I would say the same, not because there are not other precepts to be explained, but, if humility does not precede and accompany and follow every good work we do, and if it is not set before us to look upon, and beside us to lean upon, and behind us to fence us in, pride will wrest from our hand any good deed we do while we are in the very act of taking pleasure in it. 

https://theoldguys.org/2019/07/05/augustine-humility-humility-humility/

I'm not to try to top Augustine, so...here are a few pictures from the last 3 months, in whatever order they fall!

Back home in Kapsowar!

Welcome back party at Maternity - so grateful for everyone who worked really hard providing care while I was away

A blurry picture of our first all-female OR staff!

Enjoying a delicious treat at our favorite restaurant in Eldoret

Continuity of care is a beautiful thing. This patient has lost 3 babies (2 with me) and finally got to go home with this precious gift just days before Christmas.

First day of 3rd grade!

Dominic has learned to make coffee! He left this gift for me after a particularly difficult night of call.

My, how our community has grown!

A quick Christmas greeting

Merry Christmas from Kapsowar! 

Life has been a sprint for the last several weeks. I (Kim) am really looking forward to the return of my clinical officer, Joyce, next month, as well as a short-term volunteer to take some of the load off my work schedule. So instead of a long, picture-filled post, this year I'll write my Christmas list - but starting with the "wishes" that have already been fulfilled!!

🗹 Financial support to return to Kapsowar

🗹 Safe trip back to our home in Kapsowar

🗹 New colleagues to help with the work here

🗹 Passed my OB/Gyn oral board exam!

𝥷 School teacher or tutor for Dominic

𝥷 Fetal monitoring to replace the broken equipment at the hospital

𝥷 A full-time, dedicated station manager for our "station"

Wishing all of you a Merry Christmas and Happy New Year!!