Journal

Matt - 9/28/2021

It is hard to believe that it is time to go home. The last four months have gone by both very fast and very slow. It is getting hard to remember what life was like back in Minnesota, now that we have become so accustomed to our daily routines in Litein. We have very mixed emotions about returning home. We are very, very excited to get back to Mora and see our friends and family, and have life back to “normal”. But at the same time, we have made friends in Litein and feel torn by wanting to be in both places at once.

On our last day of work (Friday), the hospital administration and staff held a send-off service for us. In typical Kenyan fashion, several people spoke showing their appreciation for what God was doing through us over the last four months. Then they gave us several gifts and asked us to speak (see photos). This service was both an opportunity for the hospital administration to show us appreciation and for them to encourage the hospital staff in the great things that God is doing in Litein. We felt very honored.

On Friday afternoon, the crew on female medical ward that I was working with over the past few months gathered and surprised me with a cake and little going away ceremony of their own. They took turns letting me know how I have impacted the culture of the female medical ward. Again, I felt honored.

When we left for this medical mission trip, it was hard for me to know exactly what my mission was. When I think of the word “mission”, I think in military terms. When the military sends a group on a mission, they have very specific objectives to accomplish in a very specific timeline. I think that my main mission on this trip was to provide spiritual encouragement to the hospital staff. This is a difficult one to measure to know if this objective was met. On Friday, I felt like they were encouraged, and this really helped me to feel like we met our main objective. Yes, there are several other lesser objectives (missions) that we wanted to meet. I wanted to provide education to the medical residents, medical officers, and clinical officers. I wanted to help expand both their clinical knowledge and their approach to managing patients. I was tasked with the stewardship of a large donation to improve the hospital, which turned out to be a bigger task than I had anticipated. This involved a lengthy process of trying to identify the needs, move the funds through the proper channels, and work on acquiring these items in a developing country. We wanted to build relationship with the community and with the hospital. We wanted to build relationships with our children and to help teach them many things about the world that they just can’t learn in Minnesota. There were some things that I think we could have done better, but overall I feel like we accomplished our mission(s). For that we are grateful.

Through the course of the summer, I gave many lectures on various topics. One of my favorite lectures was on diabetic emergencies. Dr. Winne had asked that I speak on this, so I prepared a lecture on DKA and HHS. I gave the lecture on a Wednesday, then on Thursday we had a patient transferred from another local hospital. She was in her 30’s and did not have known diabetes. The other hospital had her for two days, but she was getting worse and they didn’t know what was wrong with her, so they sent her to the Litein Casualty. She was almost dead on arrival- comatose, pulse in the 160’s, blood pressure almost undetectable. Dr. Winnie and Dr. Faith were in Casualty that day, and they had both attended the lecture. When they called me to Casualty to review the patient for admission, the patient was already doing a lot better and starting to wake up. When I asked what they wanted to do to treat the patient, they outlined the plan perfectly. Then Winnie said something that I don’t think that I will ever forget. She said “Before when a patient would come in to Casualty with DKA, we were scared because we didn’t know what to do. We are not scared anymore.”

There is still a lot of work to be done. I still need to finish on the equipment purchase process, and I think this will take a few more months to oversee. We have been asked to help the hospital more long-term by starting a nonprofit organization to help the hospital. At Tenwek, they have been able to successfully support the hospital in numerous ways through an organization called Fiends of Tenwek. We have been asked if we would prayerfully consider starting a Friends of Litein organization. We have been asked frequently if (or when) we will come back to Litein. Honestly, I do not know the answer to this question. We would like to go back at some point, but I don’t know what that would look like. I was a little surprised when God opened the doors for us to go this time, and His timing was perfect. God only knows if or when He will send us back.

Amy - 9/26/2021

Today is our last full day in Litein. It’s been so very hard to say our good byes. Tears come quickly when I think about it. Yesterday, I was reconfirming our flights and I realized that I had been planning on leaving here on Tuesday morning, but was scheduled to leave Monday morning. Monday was designated as my packing day so since we have plans most of the day today we spent most of yesterday packing.

I have so many things to tell of our last few days. We’ve been squeezing out every last drop of our time here and so we haven’t had much time to journal. Perhaps, we will have some time during our travels the next three days.

Yesterday, I was thinking through how each of us has grown while we have been here. Mnason has spent so much time socializing with the kids which has been very therapeutic after a long season of quarantines in the states. I’ve learned that Mnason does well in front of a crowd. My shy daughter has learned how to speak to a group a people and interact with new people because she is asked over and over again to do so. People comment on the growth in her. Zethan has spent much time thinking through what he’d like to do when he “grows up” and searching through colleges. He has loved his time in carpentry and this week he spent a few hours following the surgery team around. Joah is back in the states and I think the summer was a good summer for him as well. He has been able to return to college refreshed and ready for college life. It is fun to see how he has matured. All four have gained a few job skills along the way. Abijah has spent the summer with grandma and grandpa, learning about what it is like to live away from his parents and siblings. Matt has grown so much in his public speaking and presentation skills. He’s learned so many medical things as well and seen some mind-blowing severity of diseases. “African’s are tough!” has been his saying. I have learned many computer skills and spent lots of time baking, something I enjoy doing but don’t spend much time doing in the states. Litein has a very welcoming culture and the people are so thankful. I think our whole family has learned a lot about how to make people feel welcome and how to be thankful.

I hope to write more and post some amazing photos later, but right now my day, our last day here, is waiting…

Amy - 9/17/2021

Matt was mostly recovered from his sickness on Sunday morning, so we were able to visit a small church with Joshua. The people were so very welcoming and I really enjoyed listening to the children singing. Joshua said that the people met under a tree for a long time before the built the church building. After the church service we took tea and each person took turns saying thank you to us for visiting and we were asked by each person to greet the people back in the states.

On Tuesday we were without power in our apartment for most of the day. We learned it was because we hadn’t paid for our electricity. We didn’t know that we were supposed to pay or even how to pay. The apartment has a device that you can plug into the outlet and it will tell you how many killowatts you have remaining. If you want to buy more you need to MPESA (transfer money from your MPESA account) to the electric company using your phone, and then you will receive a text with a long token (more than 16 digit number) that you need to enter into the device that is plugged in. Then, magically the electric comes back on.

We can’t imagine coming to Kenya without having or setting up an MPESA account. A few weeks ago the hospital went to strictly cashless system. Which means that the only way to pay for your service is with MPESA. If a patient does not have a fully functioning and charged cell phone then they need to find someone who does. They can visit an agent (at a shop) and give them cash in return for the agent sending money via MPESA to pay the fee. A few patients have been upset by this, but most comply easily. Because payment is received before most services, a person is not able to become a patient before they have sorted out paying the fee with MPESA. We eat at the hospital restaurant most evenings and the bill is also paid with MPESA. If you remember from a previous journal entry, MPESA must be set up at a larger SAFARICOM Customer Care Desk with a passport. The closest desk to Litein is in Kericho (a 45 minute drive away).

We celebrated Mnason’s 12^th birthday this week. Zethan made him a pair of stilts and Mnason had fun teaching the neighborhood kids how to balance and walk on them. We found him a wooden African drum with animal hide stretched across it. We travelled to Kericho two days in a row looking for it and came back empty-handed, but then a man named Marowa (our driver) located one and drove a third time (without me because I was tired) to Kericho to retrieve it. It was quite the chore to find the drum, but it is so much fun to watch Mnason play it. I made two chocolate peanut butter cakes and the neighborhood kids and some of their parents came over to sing happy birthday and share some cake. It was a good birthday.

Yesterday, Africa (Dr. Boaz’s wife) walked with us to a shop in town to have African clothes made for us. Tirzah and I picked out material and a style for dresses and Matt and the boys picked out material and styles for shirts for themselves (and Joah and Abijah, who are already back in the states). We will pick the clothes up next Thursday, shortly before we leave so we are hoping that they will be finished in time.

Time is moving so fast right now. I'm going to be sad to say goodbye to Litein. I hope to come back some day for a visit. I'm trying to savor every day here. I will be excited to be home in Mora and I am looking forward to seeing friends and family, but I'm for certain going to miss life here in Litein.

Matt - 9/10/2021

Well, I am home sick today. For those of you who know me, I really hate to miss work and stay home because of illness. We went visiting last weekend to three different people's houses, and I must have picked up a stomach bug somewhere. It is very cultural here to feed your guests, and it would be very rude not to eat food when offered. I have the same symptoms that Zethan had back in June, with fevers and intestinal symptoms. I was feeling under the weather Monday and Tuesday, but nothing specific. Wednesday evening, I spiked a low grade fever and I thought I was getting a cold. I took some Paracetamol (acetaminophen) and by the next morning I felt better and went to work. Last night, I had high grade fevers and started getting intestinal pains. At 1:00 in the morning, Amy walked with me up to the hospital and I was seen in Casualty (ER). I started ciprofloxacin and now I am starting to feel better. We don't have health insurance here (only for catastrophic coverage), so we pay cash for healthcare services. My total bill for being seen in the Casualty and getting the medication was 810 Ksh (about $8). I was supposed to go to Kijabe today with Dr. Boaz to see the hospital and help with OSCE's (an exam that the residents need to take, to test their clinical exam and decision making skills). Unfortunately, I will have to miss this. There is no way I would feel well enough to help.

The last couple of weeks, the first year Family Medicine resident Lorraine has moved over to the female medical ward to do her Medicine rotation with me. She has been really fun to work with. She is highly intelligent and very skilled. She is a lot farther ahead in her training than I was in my first year of residency. I think that she is going to be a dynamite Family Medicine doctor when she is done. She has to complete 4 years of residency, then she can be a "Family Medicine consultant". She did her internship here in Litein, and now she is back to do residency. I hope that Litein will make a position for her when she graduates, because she has already said that she would like to stay in Litein when she is done. There are actually very few Family Medicine doctors in Kenya. I have heard that the hospitals are reluctant to hire them, and as a result there have been fewer applicants to the residency programs. This year there are 10 spots in the Kabarak program (2 at each of the 5 hospitals) and only 6 applicants. Litein is praying that they will get one.

We are winding down in our Kenya experience. It is hard to believe that we have only 2 1/2 weeks left, then we will fly back to Minnesota and back to our normal lives. By this point, it is difficult to remember what our "normal" lives were like. It was a bit of a culture shock when we first arrived. I imagine that it will be a culture shock to return.

Some medical things that I have seen recently:

We had a woman that came in with altered level of consciousness, admitted overnight by the clinical officer in Casualty. During morning rounds, she started seizing. We talked through the differential and discussed the next steps in evaluation. Just by looking at her, I thought that she was going to die. Then the nurse checked a blood glucose (which had not been done before), and it read as "High" (meaning higher than the machine can read). With this, we suspected that she had HHS which is a rare (in the US) complication of diabetes where the blood sugar gets incredibly high. She was transferred to HDU and started on fluids and diabetes protocol (insulin drip, etc). Within a few hours, she regained consciousness but was delerious and combative. She remained this way for about 24 hours then slowly regained her senses. She was later transferred to the ward and she was so different that I didn't recognize her when I saw her on rounds. She was back to being a normal person, laughing and joking with the rounding team. She was discharged a couple days later, happy and healthy.

I was asked to go to the male medical ward to consult on a 15 year old boy with painful feet. He was admitted two days prior and a CT scan done that day showed that he had complete aterial occlusion of the arteries to both of his feet. On exam, both feet were ice cold and very dark in color. Both his feet had died. Surgery was preparing him for bilateral lower leg amputation, which he underwent the next day. The reason that I was consulted is because they did not know why this had happened. His exam was otherwise normal, including cardiac exam, but I ordered an echocardiogram as part of the evaluation. This showed that he has a large tumor in his heart (called an atrial myxoma), which is the likely cause for the artery occlusions. The next step for him is to go for open heart surgery to have this removed. This poor young man went from being normal, happy and healthy, to being a double amputee in a matter of a few days and now has to face open heart surgery.

We had a young woman admitted for severe eczema (dry skin condition) on her face, trunk, arms, and upper legs. Her skin had gotten so bad that she was actually septic (an overwhelming bacterial infection). She was admitted on antibiotics (and steroids for the skin), and she intitially was getting worse with higher pulse rates and fevers. I was concerned that she was going to die from sepsis. We decided to broaden her antibiotic coverage to include some very strong antibiotics like we would do with a burn victim. (These were some of the antibiotics that were donated that I brought with me.) Over the course of the next few days, she stabilized and the infection improved significantly. She started shedding large flakes of skin, to the point that her bed and the floor were covered at times. But her skin was healing underneath and by the time she left the hospital, she looked like a new person. (see photos)

We had a 90 year old woman with a gangrenous foot. She had refused surgery over the past few months, but now the pain was getting so bad that she finally consented. When I removed the bandage, I could hardly believe what I was looking at. It looked like her foot got caught in a meat grinder a few weeks ago and never healed. The front half of her foot was gone and there was bone sticking out. I was shocked, but the rest of the rounding team was not. One the medical officers just shrugged and commented "She is a strong African woman". I keep hearing that Africans are tough. The longer that I am here, the more I believe it.

We had a 27 year old woman admitted for abdominal pain. She had been seen in Casualty three times within the previous month for the same complaints and was sent home with an H. pylori kit (antibiotics to treat ulcers). When I arrived on rounds in the morning, her exam showed a distended, tense abdomen with some redness around the belly button. This is what we call a "surgical abdomen", meaning that she needs to go to surgery right away. We consulted surgery and they agreed and took her to surgery promptly. When they were doing the surgery, they found extensive adhesions and areas of infection. Every time they tried to do anything, the intestines would perforate. She was also bleeding a lot. After a few hours of working on her, and about 6 perforations, they ultimately decided that she was beyond help and they had to close. She was transferred back to the surgical ward with pain killers and "comfort cares", which means that she will die soon. I keep thinking that if the hospital would have had a CT scanner available, then she would have gotted a CT scan at one of her previous visits and this very sad situation could have been avoided.

Back in June, I had a patient in her late 40's that was admitted to the private ward for a hemorrhagic stroke (bleed in the brain). She had a bleed in the brain that had leaked into one of her ventricles (the fluid part in the middle of the brain). When she first came to the hospital, she had to be transferred to Kericho (about 45 minutes away) for her initial head CT scan. The next day, I sent her back to Kericho for a repeat head CT to follow up the bleed. These patients can develop a complication where the blood in the ventricle can clot and cause hydrocephalus, which necessitates a shunt. I felt that it was really important to get a follow up head CT. Unfortunately, the radiologist in Kericho did not. After the patient had arrived there, he called Dr. Valentine (one of the general surgeons) to find out why we were ordering a head CT just one day after she had one. She found me and I explained the situation to her, and she relayed it to the radiologist. Then he sent the patient back to our hospital without having the head CT performed. We were called to the patient's room to explain the situation to the family as to why the head CT was not done. This family appeared to be wealthy, they were all dressed very well, they asked very intelligent questions, and their English was impeccable (not common here). My recommendation was that she be transferred to another hospital for monitoring as we were unable to monitor her here because the radiologist in Kericho had refused to do the CT. They were about to ask the same thing, and had already decided on a private hospital in Nakuru. I thought that the family was mad that we didn't care for her enough. Now just this week, I heard that this family has offered to purchase the hospital a CT scanner. They thought that it was ridiculous that we have to transfer patients for urgent CT scans (I agree). Then they asked if there was any other equipment that the hospital needed. This would be a huge blessing for the hospital to receive a CT scanner, and we are praying that it happens soon.

Mnason - 9/9/2021

On every weekday I pick/collect eggs from 8:30-9:00. Sometimes I stay at the workplace but usually I go home. I have learned how to say “I want to go home.” in Kalenjin (a tribal language) It’s “ amecha (I want) awa (to go) gaa (home)”. The person I work with (the person who takes care of the chickens) is named Kiptoo pronounced “Kip-toe”. If you’re Kalenjin, you’re born with visitors, and you’re a boy, your name is Kiptoo and if you are a girl, Chiptoo. Here 10:30-11:30 is tea time. Tea here is not hot sugar water with an herb like mint. It’s hot milk, water, sugar, any tea seasonings, and black tea leaves boiled together, and then the tea leaves strained from the tea. Here everyone supports the small businesses more and the big businesses less, so here it’s easier to start a small business, but harder to keep it going.

Amy - 9/2/2021

My parents and Abijah and Joah have returned safely to the USA. We were very thankful that they were able to travel to Kenya. Joah is so excited to start his second year at St. Olaf next week and we are excited for him. I think that my parents and Abijah enjoyed their time here, however Abijah did struggle with adjusting to the change and had a very difficult time allowing his Covid test before returning to the states. The five of us have less than 4 weeks remaining here and it does not feel like we will accomplish everything that we’d like to do.

Last Sunday, we had an opportunity to attend a wedding. The couple looked wonderful and we were very happy for them. There were some similarities to an American wedding and some slight differences as well. The bride, in her white dress, danced very slowly down the aisle, escorted by a couple standing in for her parents. Her groom, dressed in a suit, and the couple standing in for his parents waited for her in front. The pastor asked the groom to lift the bride’s veil and confirm that the woman was actually the correct woman. They each raised their hands high when they were placing rings on each other’s finger so everyone could see. The wedding ended with the bride singing a song to her new husband. They did not finish with a kiss because that would be too much public display of affection. The meal served at the reception afterwards was delicious. If anyone wanted to give a gift to the couple they gave a speech before doing so. A live chicken was brought in a box with vegetables on top for the couple to use as their first meal. The chicken had started eating one of the onions. Boaz told us that people sometimes bring live goats or other livestock with vegetables strung around its neck.

Last night, Tsunami stopped by our house and we had a very good conversation about the regular struggles that Kenyan people have. There is a very difficult struggle of finding employment and the amount of cash circulating within the population is low. If someone wanted to start a business, they do not have the capital or a way of getting capital to do so. Matt was telling me last night that Britain is contracting with Kenya to hire nurses because of their nursing shortage and Kenyan’s excess of hungry educated employees. Most Kenyans see working in the USA as a means to get capital to come back to Kenya and start a business to help their people. But they are also fearful of the Kenyan government taking money from them if their business is profitable.

We have requests to help people so often, it is difficult to figure out who to help and who not to help because we cannot possibly help everyone. We’ve decided to start keeping a list of requests and needs that we see around us.

Amy - 8/22/2021

Today was such a great day! As some of you (particularly our church who have been praying) already know, today had a tad bit of terrifying at the end of it but it turned out well. We are on a safari, the vacation part of our time here in Kenya. Matt and I started the day with a 3:40AM wake up call for a hot air balloon ride. Matt had made reservations for this long before we left the states and told me about the reservations as a birthday present last week. We had a lot of fun and were surprised how we spent most of our time in the balloon just 2 meters off of the ground or the treetops when crossing tree filled areas. We even landed next to the border of Tanzania. The heat of the balloon felt wonderful in the cool morning air. We saw a lot of animals on our drive back to the safari hotel and then later today we were successful in finding many animals in our afternoon game drive. We finished our day with a yummy meal at the restaurant of the hotel. While we were eating dinner, Tirzah casually mentioned that she thought she may be having an allergic reaction. She is allergic to tree nuts and SEVERELY allergic to a few of them. Then she said her lip was starting to swell and it was a tiny bit difficult to breathe and she was nauseous. We had her take her albuterol and 2 benedryl and then decided we should wait on the epipen (a choice we would change looking back). We reasoned that we were more than thirty minutes from the hospital and that she wasn’t struggling too much and that we only had two pens which only last about 15 minutes each. But we did start searching for our driver and requesting help from our hotel for information on how to get to the closest hospital. Tirzah started struggling a little bit more to breathe and then she told us she really thought she’d vomit. We barely made it out of the restaurant and into a bathroom in time. Thankfully, she emptied her stomach. She started to struggle even more with breathing and she was even struggling to be able to take her albuterol. We gave her two more benedryls and by then the medic on the resort staff had found us. He gave her a shot of something Matt said was similar to prednisone, but her breathing continued to get worse. Matt asked if they had any epinephrine, but the medic said they did not. Then he said that he did have adrenaline (Matt forgot that is what they call epinephrine here). Thankfully the hotel had at least 10 vials. Each vile contained an equivalent of the medicine in 4 adult sized epi-pens. The medic gave her a dose of the adrenaline (epinephrine), but gave her the whole vial. The shot worked very well and she was able to breathe. She was shaky. We began monitoring her heart and blood pressure. They said they wanted her blood pressure high and it was. I believe the elevated blood pressure gave her a bit of head ache. We watched her for more than an hour more and she continued improving. Right now I am typing this as she sleeps peacefully and I am checking on her regularly. Matt will be taking over for me in a little bit. The concern would be if the shot wears off and she has a second allergic reaction.

Today was a great day because my daughter is doing well….it was a great day because we have a family and a church family who is willing to pray for us when we really needed some prayers. If you’ve been praying, thank you very much! Today is a great day because God answered our prayers. I had texted a friend in Kenya asking for prayer and the response was that God cares for my family so she will be fine. Yes, God cares for my family and I’m glad she will be fine, but if she hadn’t been fine that wouldn’t mean that God hadn’t cared for my family. God is a loving God regardless of our circumstances. We may not understand why certain things are allowed to happen (for instance, her even to have the allergic reaction) but I trust that God has a reason they’ve happened.

Before coming here, Matt and I had a conversation with a missionary who had a daughter with a tree nut allergy like Tirzah and who had to use epipens for allergic reactions multiple times while they served in Kenya. We were all very aware that something like this could happen but still felt called to be here. Tirzah’s situation here could’ve been worse and we are very thankful it wasn’t. We had talked with the chef and the kitchen staff about Tirzah’s allergy before eating, but it still happened. Perhaps this was a learning experience for us and for the restaurant. Perhaps it will prevent someone else or even Tirzah from having a closer call. My shift is coming to a close, so I’m gonna wrap this up.

Amy - 8/20/2021

My parents and Abijah arrived safely in Litein exactly as planned. It has been great to see them. We decided to have my parents wait until they reached Litein to get set up with Safaricom, one of the cell phone service providers, because we had problems with the way our phones were set up at the airport. We learned that within the past few months, Litein’s Safaricom care desk has stopped setting up service for people from other countries and that we needed to travel to Kericho, a 45 minute drive away, to get a Kenyan cell line and data for the internet. We spent Tuesday taking care of that. On Wednesday, Tirzah, my mom, Abijah, and I visited A.I.C. Baby Home Mogogosiek (partners with Chariots for Hope) . They care for children under age 6 whose parents are not able to care for them. Currently there were 46 little ones being cared for at the facility. The organization is funded solely by donations, and the children looked to be very well taken care of. They are currently in need of a commercial size washing machine to help with washing the bedding. Can you imagine the quantity of laundry for 46 children? There were tiny baby clothes and blankets hanging lots of places even inside of their cereal store (storage shed for beans/rice/grains). The littles all slept inside of cribs with the tiniest sleeping in bassinets. In foster care in the states babies under 12 months are not allowed to be given blankets or placed on soft mattresses to sleep. The babies here have very soft mattresses and fluffy blankets. They have a large garden and 4 cows to help feed the children. We were surprised that the cow’s manure is used to create gas to power the stoves. Speaking of stoves, they also mentioned that they were in need of a different type of stove so that the smoke from the fires didn’t fill the kitchen. We also saw a beautiful building that can house groups who want to come and volunteer at the facility. My dad started working at the hospital on Wednesday with Zethan in the carpentry department. Abijah followed Mnason around with the chickens yesterday and today he worked with Zethan and grandpa in carpentry. Joah, Tirzah, and mom helped in IT yesterday and today entering COVID vaccines into the Kenyan database. A lot of people do not know their exact birthday so when just a year is given we enter 01/01/yyyy for their birthday. So when you see a birthdate for new year’s day that means the person does not know their actual birthday.

An issue that we’ve been dealing with lately is figuring out how to get a visa extension. When we originally applied for a traveller’s visa it was granted for 90 days, however our stay is a little longer. When we arrived in Kenya, the officer stamping our passport said sternly to us that it was extremely important to extend our visa before our 90 days ran out. We had a difficult time understanding from what we read on the web how to do this and when we tried to create an account in the Foreign National System (like the directions said was required for an extension) the system never emailed us the verification code. What worked was to reapply for a visa in exactly the same way that we had applied for the first visa at evisa.go.ke and pay the ($51/person) visa fee a second time. We noted in the application that we were applying for our first extension and our second visa. We waited an hour and checked back at the website and were able to print our issued visa documents. We sent our passports and the printed documents with someone (thank you, Sandra) who was travelling to Nakuru, a town 2 hours away that has an immigration office in it. We’ve been told that Kissimu and Nakuru’s immigration offices are easier to work with than the busy Nairobi office. The person presented our passports and visa documents to the immigration office and they stamped all of our passports and just like that we will be able to remain legally in Kenya for the rest of our planned time here. Because I know some of you (Americans) are wondering, yes she brought our passports back.

Tonight, we plan to take my parents to game night at Boaz’s house. We are excited to bring a new game to him as a surprise. Tomorrow morning, we leave on the vacation part of our time here. We will be picked up at 9:00 and be driven just over 3 hours away to stay at the Fairmont Mara for 3 nights. We will be visiting the Masai Mara and we are very excited for the adventure. We wonder if the hippos will be noisy all night or not…

Matt - 8/20/2021

This story is about Esther. She is a beautiful 7 year old girl who was admitted today to the HDU (high dependency unit, like ICU) for cardiac issues. She initially presented with symptoms of heart failure with low blood pressures and tachycardia (fast heart rate) at 195 beats per minute. The ER provider tried to transfer her to Tenwek hospital where there is pediatric cardiology available, but they did not have room to be able to accept her so she needed to be admitted here in Litein. Following admission, she was started on dobutamine by the admitting consultant physician due to her low blood pressure (this medication raises blood pressure). This medication fixes the low blood pressure, but does not solve the underlying problem.

Fortunately, we had an ECG machine that was purchased for the hospital using funds from a very generous donation from someone from our community in Minnesota. We were able to do an ECG which showed supraventricular tachycardia (which is a fast heart rate caused by a problem in the top part of the heart). This problem needs to be fixed or will eventually cause overt heart failure and death. The medication that is used to fix the fast heart rate is called adenosine. This is not a medication that the hospital normally carries, but fortunately this medication was also donated to the hospital (by the same donor as above), and I was able to bring this with me from the US when I came here in June. I have used this medication many times on adults, but never before on a child. Dr. Boaz and I discussed the case and calculated the dose needed for her. We pushed adenosine twice, and after the second dose her heart rate went from a persistent rate of 195 down to 110 with a normal sinus rhythm. Once this happened, I was able to see her little body relax and she was much more comfortable. She was exhausted from the physical stress of having a heart rate that high, and within a few minutes she was sleeping peacefully with her heart rate controlled. Through the kind donations above, we were able to properly diagnose her issue and give her the life-saving medication that she needed (thank you so much for the donation!).

The other way to fix the fast heart rate is with electrical cardioversion, which I was prepared to do if the medication did not work (with a defibrillator machine that was also donated by a company in Minnesota). This is more risky and I am glad that we did not have to go that route. She had an echocardiogram performed (see picture) by Dr. Boaz who is in the process of learning to do these so he can do them locally. Her echocardiogram shows evidence of rheumatic heart disease, so she still has a lot of hurdles to face with likely heart valve surgery in her future, but for now she is stable and doing well.

Amy - 8/14/2021

My parents and Abijah will be arriving in Litein tomorrow evening. They left their house on Friday evening. I'm very excited to see them. The hospital has prepared a two bedroom apartment for them. Please pray that the rest of their travels go smoothly. They are currently in New York City awaiting their 1:45PM flight to Nairobi. Please click on the Prayer link to see more about this.

This weekend has been wonderful! Friday was my birthday, and someone from work brought me a whole liter of ice cream. I have not had any ice cream since we've gotten here so it was a wonderful treat. The kids went to the shops (the word store means storage) in town to buy me some birthday gifts. Zethan hung up some balloons and then we spent some time swing dancing with the kids and Tirzah also taught me the line dance to Cotton Eyed Joe. Yesterday afternoon I got my work out teaching the neighborhood kids the dances. It was so much fun!

Yesterday, Tirzah and I walked into town for some shopping and then Zethan wanted to window shop so I walked into town with him too. We ran into someone he works with so we stopped and chatted for a little while. They were selling live chickens for butcher. It was tempting but seemed like a bit of work. A man we met from church was in the group as well. He dreams of starting a business selling and training dogs for pets. He wishes someone from the states could help him acquire a good breed that he could breed and sell. I met a young man in his mid 30s named Tsunami. He, like so many people here, has a dream of moving to the United States. His education background is in Information Technology.

We've been here for almost three months and I'm still surprised at how excited most everyone is to meet someone (especially someone with white skin). I think this is a great contrast to how Americans tend to treat newcomers. I'm realizing how paranoid...or shy....or possibly even rude ...Americans may seem in comparison. What a shock it could be to come from such a welcoming culture and not receive the same welcome in return. I'm not sure if I'm using the correct words because I know that many Americans are welcoming (or want to be welcoming) especially once some time passes and they trust you.

This morning, we were able to go to church. I really enjoyed being able to sing worship songs with other believers. The services feel very similar to church services from when I was a young girl. The choruses sung are the same ones. During the service, the song leader had us turn to someone else and say thank you for coming today. Indeed, I was thankful the others had come. Hopefully, each person left feeling thankful that they had come. The pastor preached about the time that Jesus was asleep on the boat when a storm was going on. Why could Jesus sleep when such a problem was going on around him? The pastor spoke about peace in the midst of the storm and the importance of having Jesus in your boat. He also spoke on Philippians 4: 6-7: "Do not be anxious about anything, but in every situation, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus." This morning was a great reminder that peace comes by being thankful and by praying and trusting in God's love, help, guidance, and his way of living. I know all of this very well from experience, but I am grateful to have been able to go to church to hear the reminder today.

Matt - 8/8/2021

This week has been a good one. The week started out very busy. We started the week with over 30 patients in the female medical ward. Every bed was full, the side room was occupied, and we were taking up beds in the surgical unit across the hall. They even placed three beds in the central corridor to make room for more patients (see picture in the “Trip Photos” tab). My first day of ward rounds this week lasted 5 hours- probably a new record. By the end of the week, many of the patients had gotten better and were discharged home. By Friday, we were down to 12 patients. We had only one death this week, and that was an expected death in a patient with metastatic cancer that was terminal. We had three patients go home this week after more than a month in the hospital.

We also discharged a young girl named Deborah who was very ill with a brain infection called HSV encephalitis (see picture in the “Trip Photos” tab). She is a shy girl that would always smile and turn her face away from us when we approached her bed during ward rounds. She
Ainitially presented with fevers, headaches, and seizures (new for her). We treated her with 21 days of IV acyclovir (an anti-viral medication), and she recovered well. Unfortunately, the family had difficulty in buying the medication and this created a financial hardship for them. We tried to stop the medication early after only 10 days and switch to oral medication, but then she relapsed with seizures so we needed to continue for the full 21 day course. The family was able to get money from extended family members and fundraisers to provide the treatment for her. This disease has a 20-30% mortality rate, even when caught early and under the best of medical care. This week, she was able to return home happy and healthy. It was a good day.

Last weekend, we traveled to Nakuru and stayed at Kabarak University Guest House. They have a pool, and we were the crazy Minnesotans that swam in the pool in the early morning hours during their cold season. It was kind of cold (even for us), but it was a lot of fun to swim. We were able to visit Nakuru Lake National Park on Saturday evening, then Sunday we traveled to Lake Naivasha for a hippo boat tour and Crescent Island game park, then to Hell’s Gate National Park in the afternoon for a hike down this famous gorge and hot springs area. It was great to get out of Litein to see some of the beautiful areas around Kenya. We had a great time seeing all of the different animals at the parks. We are looking forward to going to Masai Mara in a couple of weeks when Abijah and Glenn and Shirley (Amy’s parents) come to visit.

While in Nakuru, we visited Kabarak University. Dr. Jonathan Nthusi is the head of the Kabarak Family Medicine residency program (the program that oversees the residents that I teach in Litein), and he was kind enough to give us a tour of the University. Amy stayed back with Mnason and Tirzah who didn’t really want to go. Joah and Zethan came with me. We met the Dean of the Medical School (which encompasses their nursing, clinical officer (like a PA), and residency programs). There is not currently a medical school for physicians at Kabarak, but they are planning to build a campus hospital and expand to this program. We walked around the University and saw the different buildings. We ended up passing by the School of Music, and with Joah and Zethan along they just had to stop to see it. We ended up spending about 2 hours there, with everything from dualing pianos between Joah and one of their students, to a music demonstration of African string instruments, to a classroom discussion with their upper level students about the interchange between medicine and music, to finally meeting with the Dean of the School of Music. It was not what I was planning when we visited the University, but it was a cool experience and fun to take advantage of this unique opportunity.

Yesterday, we were invited to go to Brenda’s house. Brenda is our house helper, and we interact with her on a daily basis. We were able to meet her family and see her church. Her husband’s name is Hillary (which is only a man’s name in Kenya), and her oldest daughter Deborah and two young sons Jared and Jethro. We met her neighbors/friends/church members next door (Fancy and Denis) and their three young sons. They are very nice people. Denis works as a math teacher at the local high school. We met several other neighbors and friends in the area. It is a common part of their culture to have the privilege of greeting visitors. Everyone wanted us to come to their home to take tea, but Brenda was good at telling them that we would be honored, but they would need to wait until next time. In the afternoon, they drove us to a hilltop in the area with some amazing scenic views. We were then brought to a haramba to support one of their church members. We had no idea that we were going to stop there, but we were paraded in, brought up front to sing and dance, then we exited. It is a very strong part of their culture to welcome visitors and ask the visitors to speak and sing. I was concerned that we would be trapped at another very long fundraising event, but we were only there about 30 minutes. We noticed that as we drove around, virtually every person that saw us would stop what they were doing and just stare (usually with a confused look on their face) as we drove past in the car or on the motorbike. As we would drive around, sometimes the driver would stop and the people walking on the road would want to greet us (shake hands and say “hello” or “hi” in English). It was a fun day overall, but we were very tired and “peopled-out” (as Amy would say) by the end of the day.

We get nearly constant requests for money, sometimes veiled and sometimes very obvious. It is not at all rude in this culture to ask for money or things, especially from someone that you would call a friend. We have found that many people want to befriend us, possibly for that reason. Usually the requests for money are for something very specific like to pay for books or schooling for one of their children, or for some capital to start or advance their business. We have found out that it is rude in this culture to say no when asked. Not that you actually need to give them money, but you need to tell them that you will consider their request. We also want to be careful not to promise to give them something. People here are very used to waiting (sometimes a very long time) to get what they want or need. Telling them that you will consider their request is a way to acknowledge them as people worthy of your consideration, and also gives them a small amount of hope that eventually they may get what they want.

We have also found here that people are very dependent on each other to meet their needs. People will share their material goods very readily with their network of family, friends, and neighbors. In this society, there is a lot of insecurity. There is insecurity of food, water, employment, electricity, etc. You never know when everything that you have may disappear due to circumstances outside of your control. I think that this is part of why relationships are so important. If a person has relationships, then they can lean on their friends when they need to. They also realize that even if they have an abundance now, it is quite possible that they could lose this rather quickly, so they commonly will support their friends and neighbors financially so they can have future security if they need it. If an older man has a good job or business and starts to accumulate wealth, he will likely have 20-30 people that he is giving money to for ongoing support. Their investment is not in the stock market, it is in their neighbors. Perhaps we could learn something from this.

This insecurity also makes their dependence on God more obvious. In America, it is easy for people to go through life in middle-class luxury and not realize how they need God in their lives. Here in Kenya, the people really rely on God on a day-to-day basis. God provides for them through His people, which is their network of friends and family within their local church. Doing church here in Kenya is about doing life together (quite literally), which is something that our local church (Trio Church in Mora) has been trying to integrate for quite some time.

Tirzah - 8/8/2021

Around a week or two ago, Mom and I went on a walk for around half a mile down the road. While we were walking, a girl, maybe a year or two younger than me, came up behind us and introduced herself. She was carrying a water jug and told us she was going to fetch water. Mom asked if the girl would show us how to get water because we didn’t know how. She led us down the hill and down a very bumpy path on the side of the road towards a couple buildings and a lot of people. When we got down the path, she showed us a cement block with a pipe sticking out of it and water flowing out of the pipe. Several people were already there, I think they were the girl’s family, with the same big jugs. They took the water jugs and put them in the flow of water so they would fill up. Then they carried the jugs back up the kind-of steep hill and up the hill on the road.

While Mom and I were walking back, two boys caught up to us from behind. They introduced themselves to us and told us their ages. Mom introduced us and told them my age. They were 15 and 17. Then the 15-year-old boy asked, in an expectant tone, “So… You will give me this girl when I finish school?”

That caused Mom to laugh a bit. She responded by telling them that in order for him to marry me, we would need to have a relationship. He kind of looked a bit confused when she said that, but soon after they left us and turned down a side road.

Last weekend, we went to Nakuru, a two-hour drive from Litein, and stayed at the Kabarak University guest house from Saturday morning to Monday afternoon. On Saturday we went to a Game Park by Lake Nakuru. Our driver drove us around the park, and we got to see a lot of animals. The top of the car was able to lift up and that allowed us to stand up the entire car ride. The animals we saw were Cape Buffalo, Antelope, Rhinos, flamingos, various other birds, and more. My favorite animal that I saw was a white rhino. Lake Nakuru is one of the few places in East Africa that has white rhinos.

On Saturday, we went to Naivasha, a two-hour drive from Nakuru, and went on a boat ride around the shores of Lake Naivasha to see hippos. At one point, we went past a small area where there were about 20 to 30 hippos all lying in the same area. Our boat driver told us that there are two different families of hippos, and those hippos couldn’t go near the other family, or they would fight. After a while, the boat driver brought us to Crescent Island. There, we got out of our boat and met a tour guide. He brought us around the island and showed us the animals and told us cool facts about them. We were able to get within five feet of a zebra and within ten feet of a giraffe. We saw Zebras, Giraffes, Wildebeests, more Cape Buffalo, Impalas, Water Bucks, several species of birds, and more. I didn’t know what an Impala was until then. The fact that he told us that I thought was most interesting was the one about Impalas. He told us that they have scent glands on their back legs that will open and leave a trail on the grass when they feel threatened. The group will scatter but be able to find each other again because of the scent glands.

After the tour around the island, we got back onto the boat. The boat driver took us to a different island and told us he was going to whistle and throw a fish into the water so a fishing eagle could catch it. Almost all the eagles they have here look like bald eagles. The boat driver did what he said he was going to do and threw the fish in the water. The eagle then stared at it for a second the dived at it and grabbed it out of the water and flew off towards what I’m guessing was its nest. After that, we were brought back to shore and met our driver again.

After we had lunch, we drove to another game park called Hell’s Gate. We saw almost the same animals as Lake Nakuru, but we didn’t see any rhinos. A ways down the road, we pulled into a parking lot and were told that we could pay for a tour guide to take us on a hike around the park. We could choose between a long hike or a shorter hike. We chose the longer one. The path we hiked on was a well-trodden path, but it still was hard to go on. After a while of hiking, we got to a division in the path. The entire time we had been hiking, except for the very beginning, had been in a gorge. The path divided into two gorges. Our guide told us that a movie had been filmed there and it definitely looked like it. The movie was Tomb Raider. We went down one path and got about halfway to the end and found a rope hanging down the side of the cliffs that were surrounding us. We were told that we could climb up if we wanted to, so all of us did except for Mom.

After we climbed down, we continued towards the end of the path. When we got to the end, we reached a large area that looked like a cave. It’s called The Devil’s Bedroom. That was where Tomb Raiders was filmed. We then walked back the length of the gorge and then headed down the other path. The guide showed us some hot springs that were coming out of the side of the cliffs. The hot springs joined a stream that was flowing down the center of the gorge. We would have gone down the gorge further, but we had spent too much time exploring the path to The Devil’s Bedroom. We went up a long staircase to the top of the gorge and at the top there was a market selling a lot of jewelry made from beads and a lot of wooden trinkets. There were about eight different stalls and all with people trying to convince us to buy from them at the same time. Everyone wanted us all at their table at the same time and to buy everything they had for sale. In the end, we ended up with one bracelet for me, two bracelets for Mom, and a couple trinkets that we could use as a Christmas tree ornaments. After that, we walked back to our driver and drove back to Nakuru.

On Sunday night, we decided to use the pool at the guest house. We woke up at 7:00 AM the next morning, so we could be in the pool by 7:30. We ended up there by 7:15. Mnason thought the pool was too cold so he only stayed in it for 15 to 30 minutes. Zethan and I stayed in the pool for almost 2 hours. Dad came and joined us for the last 45 minutes and Joah joined us for the last 15 to 30 minutes. We then went for breakfast and left the hotel at around 11 AM to drive back to Litein. I thought the trip was very fun.

Yesterday, we went to Brenda’s house. Brenda is our house helper. We stayed at her house from 10:00 AM to 6:00 PM. We had lunch and two tea breaks there. She showed us her church, her neighbors houses, and her parents in law’s house. It was a lot of fun. One of her neighbors gave us a bag of avocados and her mother-in-law gave us a pumpkin. We went for a drive around the area and to the top of a hill with a very beautiful view and took a lot of pictures. Because we couldn’t all fit into one car, Mnason, me, and Brenda’s oldest daughter went on a boda (motorcycle). Our driver didn’t know where we were going, so we got slightly lost and went down the wrong road. Eventually we got to the top of the hill (which was more a mountain than a hill) and there was a water tower that was circular and about 8 to 10 feet tall. There was a ladder that you had to climb to get to the top and it was a very pretty view. After about 5 minutes, all of the people that rode in the car arrived. Maybe 20-30 minutes after they arrived, we went back down the hill and drove back to Brenda’s house. On the way back, we stopped at a haramba (a money raising gathering). I had no idea we were going there, but they made us get up and dance and sing to a song we didn’t know. We were only there for maybe 10 minutes. When we left, the boda ran out of gas halfway to Brenda’s house so we went past the driveway and into town so we could get gas. When we got back everyone was confused why we didn’t arrive first and came from the opposite direction. Once we explained what happened, we went inside and had tea and mandazi and left afterwards. I think we all had fun.

Amy - 8/2/2021

This past weekend, we travelled to Kabarak University in Nakuru because Matt wanted to tour it while we were here. The family practice residency program that Matt is working with is through the school. The university runs a hotel called the Kabarak Guesthouse (https://kabarakuniversityguesthouse.com/), which is where we stayed. It is a very nice hotel and the food was very good. When we booked our rooms we were given the choice of paying for full board (which is 3 meals and some teas) or half board (which is Breakfast and Dinner). The kids enjoyed jumping on the trampoline and swimming in the outdoor pool. It was a bit too chilly for me, but the rest of the family swam. The fitness center was really nice too. We also enjoyed having access to the hotel wifi where we were able to finally view facebook pictures easily. When we use our internet at our house, Facebook viewing is set to not show pictures or videos unless you pay an extra fee and also the pictures and videos take too long to load, but the hotel’s wifi loaded everything well.

We hired a driver for the weekend by contacting Patrick (254 721909866/pwachira32@yahoo.com). Our driver’s name was Peter. We do not want to drive in Kenya because the driving style is a lot different than in the US. Think constantly driving in a suicide lane….people pass constantly even right into the lane with oncoming traffic. Also, think many large potholes and people and animals in the roadway. So we were very thankful to have someone drive us around.

On Saturday, Peter drove us around Lake Nakuru National Park. Our vehicle’s roof could raise so we were able to stand up and look at the animals through the roof. On Sunday, we drove to Naivasha and started the day with a boat ride to see the hippos and then a tour of crescent island to see some more animals. A movie was filmed on the island that used some of the African animals and then after filming, the animals were left on the island for use for tours. The animals are wild but used to seeing people. For example, we were able to get within 2 meters of a giraffe. In the afternoon we drove through Hell’s Gate National Park viewing more animals, including a baby giraffe in a tower of giraffes. We ended our day with a hike through the park, which included going through a spot where part of the movie Tomb Raider was filmed and finding some of Hell’s Gate’s hot springs. Hiking is my thing so the hike was by far my favorite part of the parks. You are required to hire a guide for the hike and at the end of the hike is a mini flea-market where you can by trinkets and beverages. The rock formations on the hike were magnificent! Some of the animals we saw this weekend were antelope, cape buffalo, white rhinos, water bucks, flamingos, gazelles, warthogs, fishing eagles, marabou storks, zebras, giraffes, hippos, pelicans, ibis, gray herons, egrets, crested cranes, wildebeest, and impala gazelles. We saw much more, but I’m just not able to recall all of the names. The beauty of God’s creation never ceases to amaze me!

Amy - 7/29/2021

Last weekend we went to visit Juliet’s house. Juliet is Dr. Boaz’s house helper. She lives about a thirty minute drive from Litein. She and her children live on her father’s land and she is dreaming of working as a house helper in the United States for a year so she can earn enough money to buy her own land for her children. She is one of twelve siblings. It is customary for the boys to stay living on the family land and the girls move to their husband’s land, returning to their father’s land only for a time if something should go wrong in the marriage. Juliet is a wonderful house helper and a very nice woman. We are similar in age. Juliet’s family’s land is a beautiful place.

Check our photos page for some photos and videos of our day with Juliet’s extended family. When we arrived we were greeted with tea and mandazi and by many of her family. We chatted and Zethan taught some relatives how to play 500. We took a walk down the long hill to the river. It was beautiful! The river is where they collect water during the drier months when the rain water collected runs dry. We returned to Juliet’s house stopping by one of her brother’s houses briefly and passing through her brother’s fields that he plants by hand. They are large…he must work hard! We had more tea and some fruits and then lunch. It was delicious. Then the kids spent some time playing with Tirzah’s rubik’s cubes and teaching more of how to play 500. Then we ventured over to Willie’s house. Willie is another one of Juliet’s brothers. There were a lot of chairs set out at his house and we all sat down. We were not the only visitors. A group of people had travelled more than 30 kilometers to thank Willie and his family for helping a girl that he had found sick on the side of the road. He had prayed for her and drove her to the hospital. The visitors sang and danced and gave speeches about how grateful they were to Willie and his family. We all took tea and our family was also asked to sing a song. We were not prepared to sing but we gave it a shot anyway. As a large group we all had tea and then we went inside to Willie’s house and had more tea inside and then they fed us dinner and more tea. Juliet’s family was so incredibly hospitable and we really were grateful for their kindness and for them being willing to share their day with us.

We didn't mind being a little late getting home for curfew, however our drivers did need to drive us home quickly in the dark. It is NOT like driving in the US. The cars share the highway with walking people and groups of cows and many motorbikes all late and hurrying home before the roadblocks were put in an hour or so post curfew. Every night at curfew sirens begin blaring in town warning everyone to hurry. When we arrived by our apartments the driver turned to Matt and said, “We thank God that we have made it!” Yes indeed!

Zethan - 7/23/2021

It has been one month since I’ve last journaled, so I apologize to those of you who have been long awaiting our next journal entry.

Since I last journaled we went to a ‘Niyama Chama’ or meat party for the 4^th of July. This is the equivalent of a BBQ and for the record was not for the 4^th. They had 3 grills set up for roasting goat, chicken, and more goat. Dr. Boaz won the marinating competition (sorry Dr. Blasto) with more flavor despite the deficiency in moisture. We went to Kericho town for the second time this trip and I had the experience of almost getting killed by a piece of orange roasted duck for less than 18 dollars. It was the best tasting duck that I have ever eaten. It was so good that I forgot to chew the first piece completely.

Back at the hospital I’ve been working in carpentry. I have almost made 50 pairs of ½ crutches. I am making progress, but I tend to injure myself regularly and I can no longer count my hand injuries on what is left of my mangled hands (11 unhealed total). I am beginning to think about purchasing my own box of adhesive bandages because at this rate I will exhaust the family supply of basic first aid (I’m only half joking here).

Each week, I have followed my father through rounds in the female medical ward; Listened to morning lecture halls on both thyroid conditions and diabetic ketoacidosis; and Tumaini Clinic (This is the Friday Morning Mental Health Clinic). It has been very interesting, and I have seen conditions from Encephalopathy (Seizures) to Abdominal Abbesses to Schizophrenia. I confess, I can’t differentiate one treatment from another. I am still not a doctor, and I am still just a 16-year-old standing in an African Hospital with little to no clue what is going on, but it is still a unique experience to undergo.

In addition to my volunteer time at the Hospital, I have been running regularly since the second week of June. For any Coaches who are interested I have run 47.75 miles this summer. I am still increasing the weekly milage and am at 14 miles per week with 70 days left in Kenya. I have also picked up a few phrases here in Kenya such as “Tucci Tana Kesha” Which Means ‘See you Tomorrow’. Other Phrases include: “Lala Salama” which means ‘Sleep well’ ; “Missouri Sana” which means ‘ very well ’ or ‘I am doing very good’; “Jambo” which means ‘Hello’ ; and the passing greeting of “Ya-mo-nay” response to which is “A-cha-ma-gay” in the native tongue of the Kipsigis. These phrases have become a normal part of our family’s vocabulary.

All-in-all, life is well in the Schultz Family household. Thank you, to all our friends and Family for all your thoughts and prayers! (They have been very much Appreciated!) Going forward I hope to take some pictures while I am here and get them posted for you all to see. I will keep you all updated as things here in Litein progress. Once again, Thank you for all, we miss you and are very grateful for your continual support!

Amy - 7/23/2021

The neighborhood kids spend most evenings on the patio outside of our front door. The patio has a short steep ramp that the kids love to run, ride bike, and roll a tire up and down. They come to the door often in the evening asking to play with the cards (and spoons), chess board, soccer ball, and the color cube and of course Mnason. Sometimes Mnason just wants to stay in bed and sleep or read.

Each Thursday evening I’ve been attending a group study about Christians interacting with Muslims. Mainly, I’ve been learning about the Muslim beliefs which I believe are important for Christians to understand. I have not had very much contact with Muslims here in Kenya, and from my observations, there seem to be many more Muslims in Minnesota. Last night, during our group time, I was bitten by something that had found its way into my shoe. It hurt quite a lot and felt similar to being stung by a hornet. It turned out to be a big warrior ant…google it if you don’t know what it is. It was about 2 cm long. I was surprised to find that my foot didn’t even swell. I hope that doesn’t happen again!

I’ve been having conversations with people about the boarding schools in Kenya. Most children are sent to boarding schools at a young age. In the past buses weren’t available and it was easier to have the kids stay at the schools as compared to transport them. Nowadays some schools provide buses, so some kids get to stay with their families. A man in IT told me he was in the first grade when he was sent to boarding school and he said he was so scared and didn’t want to stay. He said that students were regularly beaten/caned for falling asleep or being too loud or not turning in an assignment or not having clean clothes (that they had to wash by hand on their own). He said they were woken up every morning with a whip of a cane. He said that the canes were often rubber-coated wires. He told the story of how another student who was a fast runner had grabbed his hand to take him somewhere. And he couldn’t keep up so his feet were banging on the ground as they passed the door of a classroom. I asked if he got into trouble for running and he said running was allowed but being loud was not. The teacher was so upset that each boy received 10 canes each from 20 different teachers….for being too loud while running. When I asked the man why he didn’t complain to anyone about being caned so much, he asked me how he could tell anyone. He said that they didn’t have phones or even money to buy stamps to send a letter. He said after being beaten so much, if you told your parents that you got into trouble you thought you would risk your parents beating you for getting into trouble. I’m guessing with communication being easier for students now and because the students being beaten so much in the past are now adults with children, the school discipline policies will have to change, otherwise everyone will find other schooling options. From an outsider’s view, it seems the harsh discipline is stifling kids’ ability to really excel in their academics. It’s hard to learn when you are tired or worried about being beaten. Currently I hear parents complaining about how the kids are kept up late and woken up early but beaten if they are too tired and fall asleep in class. I hear parents being nervous about the experiences their kids will have at boarding school.

The boarding schools are on break right now. The kids all went to their homes last week and they will return to the schools this week. The group of kids in the neighborhood has grown in number and we are missing the 10:30PM and 6:30AM songs each day. I do enjoy the music, but I also enjoy sleeping a little bit more.

Victor Kipkoech - 7/9/2021

We are colleagues with Amy in IT department and we mostly share much together with all the rest of the members of the department.

I shared with Amy today of what happens and what goes on in Nairobi especially with city buses called (Matatus) in Kenya or (Manganya) in Nairobi. These matatus are really modified and decorated with paintings and graphics drawn on them. I was showing Amy of a certain bus that has TV screens and huge entertainment systems which they put loud music in them and their passengers have nothing to say about it. The conductor(ticket taker) in one of the bus that I showed Amy was hanging out of the door which looked risky but they have mastered hanging on them. Also new buses in town are really celebrated with people hanging outside the buses and some on top of them just to welcome a new matatu in town.

Matt - 7/7/2021

On Saturday, we were invited to a nyama chama (literally translated “burnt meat party”- we would call barbeque) with the medical community. There were several doctors, nurses, and clinical and medical officers present. Drs. Boaz and Blasto organized the party and provided the grilling. In Kenya, the traditional choma (“burnt meat”) is goat meat, so we ate goat meat and chicken served with ugali which is a ground corn dish served the consistency of solid malt-o-meal. They also served fried plantains, a tomato vegetable dish, soda and water. Amy brought chocolate and banana/pumpkin muffins to share. The food, especially the choma, was very good. At the close of the festivities, each of the leaders spoke for a few minutes. I am finding out that this is very normal in their culture that they would ask people to speak, even if what is said is repeating what was said previously. I keep getting asked to speak during these occasions, which is difficult for me given my introverted tendencies… but I am trying.

Every Friday, we have been getting together with Boaz and Africa (Boaz’s wife) at their house for game night. The first week, we played Settlers of Catan. Then the next week was card games with Spoons and Mau. The next week was Ticket to Ride, and this Friday we played a marathon game of Monopoly. It is great to unwind from the week and eat, laugh, and play games with their family.

On Mondays we go to Boaz’s house for praise and worship time, which he calls Eventide. It is a really fun time to get together and worship together in song and prayer. Sometimes, other people from the hospital join us. This week, a young married couple from Uganda joined us. The husband (his name is Opion Peter Paul, we call him OPP) works here as a medical officer, and she is a OB/GYN resident in Nairobi. Due to COVID, the medical schools were put on hold, which means that the students were not graduating, which means that there are no new interns to work in the hospitals over the last year. This caused her to be forced to stay in Nairobi as a medical officer, and also for the hospital in Litein to have the medical officers working extra hard to fill in the gaps. They have been married for 6 months, most of which has been spent apart. Due to their recent wedding, we asked about some of their customs. This lead to a very interesting and lively discussion about the customs of paying a bride price. Yes, they still do this. In fact, in recent years the bride prices have increased because each bride (and bride’s family) want to be more valued than others before. The bride prices are always paid in livestock, usually goats and cattle. OPP had to pay 100 goats, 70 cows and two camels. So they had to go to the northern part of Kenya to find camels for this. OPP is still working on paying off the bride price. [Some couples have been married for more than 20 years and are still trying to pay off the bride price.] Surprisingly, the women were OK with all of this. They feel more valued if more is paid for them. They said that people are waiting longer to get married because they need to get enough money for the bride price, but also provide a house, furniture, savings, etc. Even to date, the man has to have a lot of money. If he asks a girl to go on a date, she may bring 1-5 friends with her and he is expected to pay for them also. Maybe this is why the young men in the IT department that Amy works in are all unmarried as of yet.

Last week on Friday, we had a visitor (Dr. White) from the US who is a family doctor with a strong interest in mental health. His brother is a cardiothoracic surgeon who is very involved with Tenwek and the building of their new cardiac hospital that is currently under construction. Dr. White has a personal history of depression and really has a heart for mental health treatment, especially with a Christian perspective. He has a vision of establishing an inpatient mental health unit in the region. There are currently no mission hospitals in Kenya with inpatient mental health. Litein has started a mental health program, largely under the leadership of Dr. Loftus. They have a mental health clinic each Friday called the Tumaini clinic (the name translated from Kiswahili means “hope”). [For those of you in Mora- yes I did tell them about the Recovering Hope treatment center.] The Tumaini clinic has a couple of mental health nurses and psychologists that work throughout the week with inpatient and Casualty (ER) patients with mental health needs. Dr. White gave a CME about mental health from a Christian perspective. I was pleasantly surprised to see the very large turnout for the talk, and for the enthusiastic applause he received when he described his vision for increased mental health services and inpatient mental health unit. It would appear that Litein would be a natural fit for this, as they already have a lot of local interest and experience in mental health, which is not common in this region of the world.

It seems like we are meeting a lot of people from Samaritans Purse recently. Two weeks ago, we met Tom Boeve who is the assistant director of World Medical Missions (see previous post). On Sunday, we had supper with Dr. Lance Plyler who is the director of World Medical Missions who happened to be in Litein. Both are very nice and down to earth people. They were in Litein to see the campus, provide encouragement, and strengthen the relatively new partnership between Litein and WMM. Litein hospital is applying for funds from WMM to start a COVID unit to care for COVID patients during the looming pandemic. The US has mostly gotten through the pandemic, but Kenya is still in the thick of it.

Today, there was a big event at the hospital to receive the bank president from Equity Bank, which is a Kenyan bank that has grown into the largest bank in east Africa over the last few decades. This bank has provided a truckload of PPE for the hospital to use in the pandemic, and has committed to continuing to supply the PPE for the next 18 months. The event was done the African way, marked by students singing, tree planting, multiple community leaders giving speeches, with lots of pictures and fanfare.

Some medical things from this week:

We had a patient in her 30’s with history of alcoholism and pancreatitis who presented with abdominal pain. CT showed a huge peritoneal abscess, measuring 2 liters on CT. She was transferred to the surgical service for surgical management. Her family was playing games with paying for her care. They would say they were going to come with money for the surgery, then leave 2 minutes after they arrived. She was clinically stable, so the surgeons waited for the family to pay before she had the surgery. She was in the hospital over 5 days on IV antibiotics before she finally had the surgery performed. She ended up having over 3 liters of pus drained from this abscess during surgery. It is my understanding that she is doing well now.

Pre-payment for medical care is an unfortunate reality for patients in this area. The hospital needs to charge money to keep the doors of the hospital open, and tries to provide discounted care when possible. But if the hospital performs the surgery without charging first, then many families refuse to pay later and this is not sustainable for the hospital. I found out that there is a needy patient fund that is run by the surgeons. Each of the three surgeons has money deducted from their paychecks each month to put into the fund. [Note that Kenyan surgeons are not paid nearly as well as in the US.] When there is a patient who really needs surgery but they really cannot afford it, the surgeons pay for the care through this fund which is essentially out of their own pockets. What a remarkable example of dedication to serving the underserved.

I was at the hospital late last evening helping to care for a 17 year old girl who was pregnant and started having eclamptic seizures at home. She was brought to a neighboring government hospital and delivered (baby is fine). Unfortunately, she had multiple seizures the next day and was having trouble managing her airway. She was transferred to us because we had a ventilator available. Ultimately, she ended up intubated and sedated while we are treating her seizures and eclampsia. We found a large hematoma on the back of her head, so she likely fell during one of her seizures at home. We sent her for a head CT today, and she has a contusion (bruise) of the brain, but luckily no brain bleed. She is still ventilated for now and in critical condition. Amy and I are praying for her.

We have a 13 year old girl with meningitis that has been in the hospital for 10 days, but getting worse over the last few days. She is on a strong antibiotic. We tried to give her two stronger antibiotics, but she broke out in hives. We sent her spinal fluid for culture 10 days ago, but the lab cannot seem to give us an answer as to what the bacteria is so we can tailor the antibiotics. I was really stuck on what I can give for meningitis with her allergies, so I sent an email to Nick (our amazing infectious disease pharmacist in Mora) and he was able to give me great advice on direction to go with the antibiotics. We just made the change today, so we will know in 1-2 days how it is working.

Amy - 7/7/2021

I’ve been taking Wednesday afternoons off each week. Today, I cooked more pumpkin muffins, which are similar to what Kenyans call queen cakes. Someone from work brought me another pumpkin so that I could roast the seeds and make muffins for them to give to their wife to try. People are surprised to find out that you can eat the seeds inside of a squash or pumpkin. If they are not using them to replant, they always throw them away, but I think they are tasty and nutritious roasted. Also, I’ve been surprised that people have never tasted fruit pies. I’ve shown pictures of pies but they say they’ve never seen or tasted them. They’ve also never seen cinnamon rolls. Today I wanted to make some apple dumplings but I was out of butter. We have checked all of the supermarkets in town and people are very curious why someone would want butter and what you would do with it. They said they’d order some for me though.

This morning at work we were discussing the cost of eggs. A brown egg in Kenya costs 10 shillings (cents) and a white egg costs 20 shillings (cents). Kenyans say that white eggs are more nutritious and better for you. The chickens that produce white eggs are the ones that are free-ranging in town, eating food leftovers in peoples garbages and other things that they find. The chickens that lay brown eggs are fed chicken food to produce regular eggs for selling. In the states we pay more money for brown eggs than white and we say that brown eggs are more nutritious. I'm finding many times.

Tirzah - 7/4/2021

Yesterday we went to a barbeque with several of the people that work at the hospital. Here they call it nyama choma. There was roughly 25 people there. The grills that were used were regular charcoal grills. The charcoal was actual wood that had been burned down to coals. Most people that came brought either a side dish or some meat they had marinated. We were given some goat meat to marinate, and we made some muffins to bring with. We made two types of muffins, chocolate and banana-pumpkin. There aren’t any chocolate chips, so we just added cocoa powder and sugar. Some of the people there said that the chocolate muffins looked like brown ugali. Ugali is a rice like food that is just water and maize meal (white corn meal) mixed. We were allowed to have one piece of grilled chicken each and as much goat meat as we wanted. There was also chapati, several types of pop, a mixture of tomatoes, onions, and spices, and a few other dishes. After about three hours, it looked like it was about to rain, so everyone had to go home. By that time, all the pop and most of the food was gone, so everyone was just waiting for someone else to leave so they weren’t first. Afterwards, we just stayed at home and played a couple card games. We didn’t go to the hospital restaurant because of how much food we ate at the nyama choma. Later tonight we are going to be having dinner with a Samaritan’s Purse director from North Carolina. Dad is at the hospital right now, greeting the man.

Matt - 6/26/2021

We have been in Litein for less than 3 weeks, but it feels like a lot longer. We are settling in well with our daily routines. I am getting the hang of my work schedule with hospital rounds in the morning and clinic schedules in the afternoons. The female medical ward has been very busy this week. All of the beds are full, and they even added beds in the center isle to increase capacity. I have found out that if a patient gets very ill and needs to go to the ICU (called HDU- high dependency unit), then the patient has to pay 4000 Ksh (about $40) to get in the door, then pay for all of the meds and other treatments that they need while there. Many families cannot afford the HDU, and they tend to insist that the patient stay on the regular medical ward. We end up treating some very sick patients on the ward. People with sepsis and blood pressures of 70/40 (very low) should really be treated in ICU with fluids, pressors, antibiotics, etc. Instead, the families insist that they stay on the ward and ask us to do the best we can. Sometimes, we recommend an upper level antibiotic and the family simply doesn’t buy it and the patient remains very ill. I also found out that although 95% of patients have insurance (15% private and 80% through the National Health Insurance plan), this insurance does not pay for a lot of things. They usually have one medication in the medication class that they will cover, but anything else the patient has to buy. If a patient needs a ventilator, then they pay 17,000 Ksh (about $170 per day). The Kenyan government is refusing to pay for anything that is COVID-19 related. They won’t pay for the testing, the extra PPE that the hospital charges, ambulance to transfer to a COVID center, ventilator management, etc. We have recently had a large increase in COVID-19 cases here. Unfortunately, the COVID-19 test doesn’t come back for 3-4 days, so multiple patients on the ward are exposed before we know it. We are currently in the process of applying for COVID-19 funds through Samaritan’s Purse to set up a COVID-19 treatment center with 10 beds and necessary equipment.

I have been in more of a teaching role than I expected. Hospital rounds are almost entirely teaching, through the process of management of each patient. The hospital clinical officer (like a PA) and medical officer (like a resident) do most of the work and I am more of a consultant on how to manage the patients. I have been asked to give lectures on various topics, particularly in the cardiovascular realm. I have given four lectures in the past 2 ½ weeks. The lectures take a lot of time to put together and present. I am currently doing a lecture series on EKG interpretation for the clinical officers. It is a little hard to get the COs to care about EKGs, because the hospital currently does not have a working EKG machine. We are working on fixing that problem. EKG is a really important tool to diagnose and treat lots of cardiac issues, and it is hard to manage these patients without one.

Two weeks ago, I had the privilege of meeting Dr. Elijah Tener who is the current chairman of the hospital board in Litein. He has been serving at Tenwek for the past 31 years, and is currently the CEO there. For those of you who are not familiar, Tenwek is the flagship hospital for Samaritan’s Purse in Africa. This hospital has been very successful over the past several decades and they have built a very large referral hospital for this region of Kenya. They have grown to the point of offering advanced services such as oncology, gastroenterology, and most recently cardiovascular surgery. Dr. Tener has recently prayerfully decided to leave Tenwek and take over as CEO of the Litein hospital starting this October after the current CEO (Joshua Tonui) retires. When he was in Litein two weeks ago, I asked if I could come to visit Tenwek for a tour. Last week, he asked me (and Dr. Boaz) to come visit and wanted me to give a lecture to the residents. I had to throw together a last-minute lecture on atrial fibrillation to present the next day. Fortunately, the lecture went well and was well received.

Some medical things that I have seen recently:

We had a 39 year old lady come in with left-sided weakness. By the time I saw her on rounds the next morning, she had completed her stroke. She is completely unable to move the left side of her body and face, and will likely never recover from this. Her friend is a nurse in the HDU here. They do not have TPA here (a clot-buster medication to treat stroke), so there is really nothing that could be done for her.

I saw a girl in clinic that was 13 years old. She and her sister receive monthly penicillin shots since 2015, and they were told that they needed to continue getting the shots until she turns 21. Initially, I thought that the prior doctor was wrong. But then after researching treatment for rheumatic heart disease, they were correct. She really does need to take penicillin shots for 15 years. BTW, rheumatic heart disease is rarely seen in the US, but here it is rampant. Lots of women coming into the hospital wards have a history of rheumatic heart disease and heart valve damage from this.

I have never seen so much Lupus. We have had several patients come in with classic SLE (lupus) features. I am not sure if there is something here that is environmental, genetic, or what the issue is. I have rarely thought about lupus in my practice in Mora. I have a couple of patients with it, but it is well controlled on chronic medications, usually managed by their rheumatologist. We had a 28 year old patient come in at the end of last week with bilateral pneumonia. We put her on antibiotics, but also high dose steroids for the possibility of something called cryptogenic organizing pneumonia. The next day she was feeling a lot better (on Friday). When I came back for rounds on Monday, she had died the day before. In retrospect, it really could have been COVID.

We had an 18 year old girl come in for chest pain. She has a history of a congenital heart defect called Tetrology of Fallot. Normally in the US, this is treated shortly after birth with a corrective heart surgery. She is 18 years old and still living with this. Her oxygen level was 75%, which is normal for her. She is scheduled to go to India in 2 months to have the surgery. Hopefully this can still happen despite their COVID-19 outbreak (both here and in India).

This week, we had 2 babies in the hospital die within about 12 hours. I was not involved in their care, but heard about it the next day. One baby they worked on for over 3 hours, using a hand bag-valve mask to ventilate the baby. Eventually, they decided to call it. They do not have a ventilator unit that can treat newborns, but they could have used one this week. I think that this may be the next project. They have a full time pediatrician (a national doctor) who is competent to manage a ventilator for newborns, and he has been asking for one. I have also heard that newborn HIE (hypoxic ischemic encephalopathy- basically brain damage from decreased oxygen at birth) is an all-too-common occurrence. The hospital did not have a fetal monitoring unit until recently. I was able to bring a donated unit with me, and they have been using it. However, I think they need a much better system.

I don’t mean to make it sound like everyone dies here. There are lots of patients who improve and go home. I do feel like I am helping to improve the quality of care here, and really the doctors and nurses are doing the best they can with what they have. However, I am just not used to seeing people die- especially younger people with what we would consider treatable illness in the US. It has been a bit of an adjustment for me, sort of a medical “culture shock”.

Amy - 6/26/2021

The week has gone well. We’ve each been working at the hospital during the week. Twice this week a hospital chaplain stopped into the IT office to pray with us and remind us of the importance of reading our Bibles each day. Also, every Thursday morning there are all staff devotions, which is essentially an hour long outdoor church service.

I’m enjoying learning about the culture from talking to the young men (mostly unmarried) in the IT office. This week they explained to me that most of the marriages are made with economics in mind. So it is normal for a young woman to marry an older man and also a young man to marry an older woman. A man needs to be able to prove that he will have a stable job and provide for a wife before he can marry. Most said that generally marriages are not based on falling in love, well at least within the last 3 years. They felt there has been a dramatic change in their culture regarding this. Also, if a man loses his job his wife will often leave to find someone else who has a stable job.

On Monday night we went to Eventide (Praise and Worship time) at Dr. Boaz’s house and some of the medical officers and a resident came. We eventually landed on American/African politics. One of the opinions was that Trump was not necessarily a good role model for a president but he left Africa alone; however, Biden has already been sending troops to Africa and they are concerned because American troops draw the attention of terrorists and then the terrorists go to that country to fight them. Then there is collateral damage when the terrorists end up missing the Americans and hurting the Africans.

On Thursday, Tirzah and I toured the Children’s home. There are currently 18 children living there for a variety of reasons, very similar to when children are in foster care in the states. There is a family who manages the home and they try to connect with each of the children who are living with them. They encourage the parents to visit with the children if they can. Cows provide milk for the children and also manure to fertilize the garden that grows the food for the children to eat. Trees were planted to provide wood for the fire that cooks the food. The home also built stores around their property that they rent out to cover their expenses. As I was leaving, we were invited to a Bible study there that evening so while the kids and Matt were eating at the restaurant I attended a short Bible study at the Children’s Home.

Today, we went on an adventure. We left on foot in search of a waterfall that people have mentioned existed. Our first stop was a store in town to find sunscreen…not something they carry (or I packed) so we continued on. We walked and walked, saying Jambo (Hi) and waving at many as we walked and walked. We kept asking if we were headed in the correct direction. We came upon a small village and a man (Leonard, aged 50) jumped up and said he would take us to the waterfall. We knew he would want to be paid; however we were in need of a guide. So we walked and walked. He didn’t speak English well and we do not speak Swahili or his language. He brought us to a quarry first and then a small stream with a culvert. We wondered if it was THE waterfall, but then he motioned for us to walk more with him….quite a bit more. In the end we did see an amazing waterfall. It was beautiful (see our photos link). And in the end, we did pay him for walking us the whole way there. Then we walked home and we made it back just in time for dinner and to make it home by curfew. We (all 6 of us) walked ten and a half miles today and our feet hurt. May be next time we will hire a motorbike or a car, but today we enjoyed the exercise and the adventure... just not the sunburn. As we were almost back home, we ran into Victor (from IT with me) and he told us that there is another waterfall that is a lot closer. Maybe that will be an adventure for another week.

Also....one more thing I should add...when Matt opened the coffeepot we realized that it did not need a filter because there is a washable one that comes with it. He has been happily enjoying his cup of "drip coffee" each morning!

Amy - 6/20/2021

Today is Father’s Day and also our 23^rd wedding Anniversary! We’ve been married for 23 whole years and hopefully we will be able to be married at least 23 more years. Our week has ended well. Zethan is completely better. Friday he went to work and yesterday his heartrate was back to normal.

The hospital owns a 16 passenger van that they will rent out with a driver for the day for $32. Yesterday we chose to go to Kericho. We visited the Safaricom (internet provider) office to set Matt up with an MPESA account, an electronic money account that allows us to pay for goods and services. I had set mine up when we first arrived. I use an app called SendWave to transfer money from my debit card in the States to our MPESA accounts. I have already used my MPESA account to pay for groceries and to reimburse someone. There is not a place to use a debit or credit card here so MPESA works very well.

We also visited a mall and three different supermarkets. We found some necessities (which included a sediment filter for our water filtration system) and a couple of books for the kids to buy, but we were never able to find coffee filters. Matt misses his coffee. They drink ALOT of yummy sweet creamy tea here, however it is difficult to find any type of coffee except instant coffee. The kids wanted to get Matt an electric drip coffee pot like we have at home for Father’s Day. We were able to buy the machine but can’t quite figure out how to get filters for it. The store employees stare at me wide when I show them pictures of the filters and try to explain that the machine they sold us uses filters. We will try to make our own filters…

At the mall, we ate incredibly yummy American food at the Java House in Greensquare mall. We had food like Bacon cheeseburgers, Jamaican Curry Chicken, Roasted Chicken, and a Breakfast Burrito. Matt even had a caramel macchiato. We also found American candy bars.

I made some monster cookies for the IT workers on Friday. It is impossible to buy chocolate chips here and very difficult to find M&Ms so I just substituted Cocoa Powder and sugar and they tasted the same. I’m going to try to bake them something every Friday for them to try.

We are thankful that Brenda started working as our house helper on Thursday. We could use the help with cooking, cleaning, shopping, and especially laundry. Many families hire others to help with house chores. She made us a large batch of chapati and some tea. The kids love both!

The area we are living in is experiencing high COVID numbers, their 4^th wave. We’ve been told it is the India variant. Some people have been vaccinated here but vaccines have not been made available to everyone. Today the churches are closed and they will be for at least 30 days. We had plans to attend a small village church today about 10K from here but can’t. Hopefully, we will have that opportunity before October. We are going to try to watch some of the services from eaglebrookchurch.com instead. There are travel restrictions so we are not able to travel from one geographic area to another. We are also under curfew and are not to be out between 7PM and 4AM. This interrupts our dinner time at the restaurant because they need to close by 6:15 so the workers have time to walk home. Patients are limited to one visitor which is difficult for this culture. I’ve noticed a decrease in the number of people inside of the hospital but an increase in the number of people outside of the hospital sitting on benches or lying on the grass. We are hoping the restrictions will lift in 30 days.

Amy - 6/14/2021

We had a wonderful weekend! Saturday was very relaxing. After Matt and I went for a short run, Tirzah helped us pick up some groceries while the boys went on a walk exploring the town. We bought a chess board and the kids have been playing it a lot. On Sunday, we went to church and it turned out to be a church service merged with a harambee (a fundraiser). We had plans to go with a man named Weldon to see his house after the service. We had been seated right behind the guests of honor and did not feel we should get up and leave especially since Matt had been asked to introduce ourselves and it would have been very obvious if we left. Eventually Weldon found us at the church. We are sorry he had waited for us for a long time, but thankful that he did. Peter came along as well. Peter and Weldon went to the same school growing up and they both are waiters at the restaurant where we eat every night. Weldon's family's land is on the side of a steep hill. It is beautiful! We followed the road to his mom's house and then followed the path down the hill to his brothers houses and then his own. We met his beautiful wife Nellie and three of their 4 children. Their oldest is in the 6th grade and is away at boarding school. The little ones were often strapped on the backs of young girls or their mothers. We were brought more food and tea. It was very tasty. We walked down the hill to see their wells and springs. We took a bunch of photos. Mnason ran and ran with the other kids. There were so many cousins! The land gets split up for each of the son's to build a house for their families. The youngest son always builds the house closest to the parents. The kids decided to race back up the hill and Tirzah began struggling with her asthma...she was a funny color for awhile and was thankful to have her inhaler. It was very kind of Weldon to invite us and of his family to share his day off with us and we loved meeting his family so very much.

Today, Zethan isn't feeling well. We are praying he feels better soon. His heart rate is a bit high and he has a fever. I stayed home from work so he isn't by himself. We have been without electricty for 15 hours now. We are getting used to the electricity and water turning on and off. We laughed (including Tirzah) because at home Tirzah took a forever long shower and last night when she was starting to take a bit too long the power shut off which meant immediate darkness and immediate cold water.

Something interesting about where we are staying....Our apartment is wedged between a girls school and a boys school. Every morning we are woken at 6 AM to hear beautiful girl voices singing and every night we hear them singing as well. We hear the boys sometimes too.

Zethan - 6/8/21:

Today marks one week from our departure from Mora. These past several days have past quickly. Our route was simple we were driven to the Minneapolis airport by my Grandpa on my mother's side. Our flight was in the air to Charolette, North Carolina by 7:15. There we spent the night in a nearby hotel, the rooms were modest but rememberable, there we were able to take our last hot showers for the summer. The next morning we took a one hour flight to JFK Airport in New York City. From there we took a fourteen hour flight to Nirobi. At first Kenya seemed not too different than the United States. The only diffence was the air temperature and the accent of the airport staff. We made it out of the airport, however one of our medical bags was kept in customs and is waiting to recieve further notice from the hospital regarding the antibiotics and prescription medicines it contained. Outside the airport we were met by our driver and to drive 5 hours to the town of Litein Kenya. On our drive I noticed the extreme contrast between poverty and wealth.There were shanty towns that stretched alongside large businesses or extravagant hotels. We would see rural herders walking cattle alongside a bustling highway. The cars swerving back and forth, accelerating and decelerating in an extravagant dance with people, cattle, busses, and other cars all trying to get where they are going faster than before. Before long we were greeted by the sight of wild giraffes, mules, and baboons along side the roadways. Eventually we came to the side of the Rift River Valley, an extremely fertile area of land that cuts deep into kenya's highlands. The veiw was spectacular. A couple hours passed and we found ourselves just outside of Litein. Since our arrival we have made acquaintances with several people from the hospital including Dr. Boaz another missionary here in Litein, and Dr. Munala, the medical supervisor of the hospital. We have also made friends with Abram our eighteen year old neighbor and are resently acquainted with Peter- a twenty five year old from church.

Zethan - 5/30/2021

As you all know, we are going to Litein Kenya. I don't know what to expect but I think my tasks will vary from day to day. I could be doing anything from helping with hospital rounds, to feeding the chickens in the chicken coops. At this point my bag is packed, I have finished my homework, and I am tying up various loose ends at home before we leave in two days. My ankle is almost fully healed and I have plans to run regularly in Litein. I don't know what God is planning for me in this trip, but I intend to trust that this is what he wants, and that I will fill an important role when I get there.