A couple of interesting dermatology cases. The first is an older man with AIDS who has developed a cancer that is associated with HIV infection called Kaposi’s sarcoma. I did not ever see it in the United States, but even a Clinical Officer just starting in practice in Kenya can recognize it. They still confirm it with biopsy, but most know it when they see it.
The next is a sad case of a very young boy whose skin is hardening with an autoimmune disease called scleroderma. This is also diagnosed with a biopsy, but when it is as advanced as this case, you know it when you see it. As it progresses you will often have to amputate the affected extremities. I am not sure there is much hope for improvement for this young child.
When we worked at Diospi Suyana Hospital in Curahuasi, Peru we loved our short term volunteers. The first time they came it was nice to get to know them. But then the second or third time they came it was a great treat! We knew them already, and we could rejoin our friendship that was formed previously. And there was something about the sensation that we were not forgotten, and that they were in it with us. We have been fortunate to even visit some of these friends in the US when we have come home. And now we are making an entire new set of short term volunteer friends in Kijabe. I know we will be so glad to see them when they return again in the future. If you want to do short term missions, find your place, and then go. Then go again. You will be a blessing to those who receive you.
Dr. John comes almost every year with his wife to Kijabe Hospital
Dr. Paul is a long term short term visitor. He is in Kijabe for a year
Visiting Dr. Rob in Las Vegas on our way to the west coast
While we were in Peru, Deb came a couple times working with a different mission, but she visited us and we went to see her when she was in Cuzco. A highlight of every December! And now also a highlight for us when we see her in Dallas.
I like going to Naivasha every week. It is about one hour from Kijabe. I meet up at the hospital with others who are going, usually one family medicine resident and the ophthalmology team. We load into the Kijabe Hospital Land Cruiser ambulance for the commute to the lakeside town of Naivasha. While there I help with any scheduled cesarean sections, round on the obstetric patients and newborn babies, answer questions from the medical officers working in the clinic, and if I have time do administrative work between cases or questions. The clinic is staffed by two doctors who did their medical officer intern year at Kijabe Hospital. A medical officer intern is equivalent to a physician in their first year of residency training in the United States. Most doctors in Kenya do not go straight to residency after their intern year, but will go on to practice in different areas of Kenya, usually rural. In those areas they will have to treat all types of advanced medical diseases, complicated obstetric cases, minor surgical cases, as well as be responsible for the administrative concerns of the clinic in which they find themselves working. It is a big job, and there is hardly anything going on in the United States that is equivalent. After a few years in these settings many go on to do a residency training program. In the United States our intern year is now combined with our residency programs, and very few doctors practice after just one year of post-medical school training. In many ways we are in a very different medical world.
One of the difficult parts of living overseas is maintaining your legal status in the country. As missionaries to Kenya, we have to register with the government and receive approval to work here in that role. We did the same thing when we lived in Peru. In both places it is a bit of a hassle, although it was more difficult in Peru because we lived so far from the capital. In Peru we would get all of our documents and then travel by plane to the capital to wait in the immigration office line for several hours to be approved for our work there. The first time we went for our immigration review, we had to have police records, many apostilled documents from the US
The immigration office is in the basement. The bathrooms are on the fourth floor.
including our marriage certificate and birth certificates, a dental exam by the Peruvian government, our fingerprints, and probably some other things that I do not remember. In Kenya it is easier in regards to documentation, but it still requires a trip to the capital. Luckily the office in Nairobi is one 1 1/2 hours from our home in Kijabe. You go and submit your documents, pay your fees, get fingerprinted, and then you wait. And you wait a little longer. By a little longer I mean a couple months. Eventually you get your alien card. Having the alien card is great because it gives you a more permanent legal status in Kenya, and it allows you to go to parks and other destinations more cheaply. You can buy a car. You are no longer a tourist! My current frustration is that I got my alien card and they only approved me until May! What!! That means I have to go through the entire process again in just a few months. Most people get a couple years of approval. At least I am getting a lot of practice in the process.
There are few things boys like doing better than trying to kill each other on Xbox!