About cairesonmission

Serving the Lord through medical missions and education.

More Thoughts

From the article “Is God For Us” by by Adam McClendon on the website “For the Church”. Thinking like he describes helps me to trust God in all circumstances, even when they do not fit what I think they should be.

In other words, God is focused on you, yes, but he does so within the grand scope of his redemptive plan for his people. It is about you, as you are a part of a greater body, and God’s securing of that body, even if that means bruising a toe to save the leg. Believer in Jesus, may God deliver us from our “me-centered” lives and help us see that he is orchestrating a tapestry of redemption, and it is our privileged to be used in any way he sees fit. If that means being faithful in a bad marriage as a witness to my spouse, my children, and the world, so be it. If that means risking it all to tell my family, friends, neighbors, and co-workers that Jesus loves them, so be it. If that means selling my home and moving to the mission field, so be it. If that means that I buy an Accord instead of a Lexis, or for most of us, I buy a used car instead of a new car, so that I can give the difference to those in need, so be it. If it means being a faithful witness while cancer ravishes my child’s body, so be it. If it means forgiving the drunk driver who killed my spouse in the car accident, so be it. If it means being faithful in the midst of great financial blessing as my stock portfolio goes through the roof, so be it.

In the end, my life is not my own. It belongs to the King. May we get our minds off of ourselves and our possessions and our families alone and surrender ourselves to God more fully. May we surrender our immediate comfort and happiness and pursue holiness saying, “God, use me as you see fit for your glory and the promotion of your kingdom among the nations.”

I differ from his text a bit as he has the comment “May we surrender our immediate comfort and happiness and pursue holiness saying . . ” I actually think the key to both short-term and long-term happiness is having this attitude.

Sophomore Restaurant

Every year the sophomores put on a dinner for staff and upper class students. Last year it did not occur. This year it looked different, as it had to be outside. Instead of serving tables, they delivered dinners to homes and a few brave souls ate outside the main administration building. We were one of them. This time of year in Kijabe it gets cool at night. So the students sat down on the outdoor basketball court around chimineas. We sat on the porch and shivered. We enjoyed watching the students try and make a go of it under tough circumstances, while we wondered why we were sitting in the cold instead of having it delivered to our house. The food was pretty good too.

img_3272

Making the basketball court look good. Allison and I sat up on the porch . . . a long way from the warm chimineas!

 

img_3273

Peter after 10 hours working in the kitchen.

Allison probably has at least 10 layers of clothing on 😉
Pretending to eat for the school photographer. Opening my mouth might make it more realistic.

Madaraka Day

Today is Madaraka Day in Kenya. It is a national holiday celebrated every first of June. It commemorates the day in 1963 that Kenya attained internal self rule after being a British colony since 1920. Madaraka is a Swahili word for authority/power. For the hospital it is a day off from routine activities. So emergency care and surgeries continue, but clinics are closed. I am on call for the ICU today. Rift Valley Academy does not celebrate any national holidays from any country and so for them it is school as normal

Mediterranean feasting

Eighteen months ago, pre-Covid, our family went to Egypt. It was fantastic and exciting and dusty and historical. We came home very enthusiastic about Mediterranean food. Since then, I crave pitas and creamy cucumber salads. I thought I would share some excellent recipes in case you would like to make a Mediterranean feast and in that way share a meal with us.

Shakshuka: who knew that eggs poached in tomato sauce could be so satisfying? It’s the feta cheese that makes this special.

https://cooking.nytimes.com/recipes/1014721-shakshuka-with-feta

Pitas: If you use allrecipes.com, you might already be acquainted with Chef John. These are a terrific texture.

https://www.allrecipes.com/recipe/232719/chef-johns-pita-bread/

Hummus: I modify this recipe a little (less tahini), but I like the very specific instructions.

https://cookieandkate.com/best-hummus-recipe/

Orzo salad: Giada has so many tasty pasta recipes. The addition of mint makes this one fun for Mediterranean night. I usually leave out the garbanzo beans and add a cheese, either mozzarella or feta.

https://www.foodnetwork.com/recipes/giada-de-laurentiis/orzo-salad-recipe-1944175

Cucumber: I love tzatziki, but it’s a bit of work. This salad is also popular at our house.

https://www.littlebroken.com/greek-cucumber-salad/

Here is David, looking cool and getting ready to chow down.

On being an extractor fan

One of the things that has given me the most pleasure in this last week is our new “ceiling extractor fan” as the box identified it. We have a (previously) white, all-tile bathroom at the front of the house that never dries out in the rainy season. It just stays a moist, humid, moldy place to get clean every day. Think of an unfinished basement with a bit of septic tank thrown in but right next to your front door. We have always had a plan to remodel it, but after nearly four years, no remodeling has taken place. So three weeks ago I made the drastic step to hunt down a fan in Nairobi and last week a couple of kindly Kenyans installed it.

The extractor fan is changing the atmosphere in the bathroom! There is no more funky smell. The mildew and mold are drying up. The towels are dried in between showers.

One morning I was thinking, “I want to be as healing and as effective as this fan.” Then I realized that God’s grace is like that fan. There are still disgusting, unpleasant things that we do and that are done to us. There is still the daily dousing that can propagate mold and bacteria, spiritually speaking, but God’s grace can keep us cleaned up, can heal what hurts, what causes smelliness and damage. I am a really good receiver of grace but I desire to be a better giver of grace. Only then can I absorb the sin, unkindness, lack of respect, and ignorance of those around me. Only as I extend the grace I have been given can I make the world a cleaner, brighter place. Just like our bathroom fan.

Our new ceiling extractor fan in the roof of our shower. That is our “widow maker” hot water heater on the wall in which water runs through an electrical heating element. So far no shocks although I have felt buzzing in the metal water pipe.

Liver Failure Week

I am back in a normal hospital ward for a change, and it feels so relaxed in comparison to the weeks I have spent in the ICU and in the COVID wards. It turns out this is the week of ascites and liver failure. I do not recall ever having so many patients with liver failure at the same time in Kijabe. Alcoholism, Hepatitis A, and still to be diagnosed causes for liver failure fill the wards. I have been opening my computer and looking up possibilities for liver failure and ascites to try and solidify diagnosis. In addition heart failure, intestinal bleeding, and bone infections round out the service.

I am glad to be on the wards, because we have more clinical officer interns and medical officer interns present to know and to train. Frequently I find myself pushed to improve through their questions. This week I am working with one specific intern who begins many of his questions with the phrase “with all due respect”. When I hear that at the beginning of a question, I know that I have possibly missed something and that my intern is feeling pretty secure in questioning a treatment plan. This intern has me on my toes, and it is good. He makes me look into why I am doing some treatments in the manner I am doing them. Have I gotten a little relaxed in a resource limited setting? Am I still pushing for excellence in the care of our patients? He knows what the book says, and he wants to know why what we do does not always match the guidelines. Often there are reasons that are sound because of the financial and logistical constraints of the hospital, but other times I am left with the thought that I should be pushing harder for increased levels of care. In this way it is a good push, despite the discomfort of being questioned. Even as I sit typing the post, I am wondering if all of the internal medicine consultants should get together to see if we should go over our guidelines again to see if we can become less constrained by our resources and push for less limitations in our ambitions.

This is ascites due to liver failure. It is a picture of a patient in Peru that I used to care for periodically when he came to the hospital.

By Annie Caire – A Repost from When We Lived in Peru –

Choquequirao

“This is going to be great,” Sarah exclaimed.

This was not going to be great. Dad was making us go on a four day hike that none of us wanted to go on, except of course, my little sister Sarah, who was very optimistic.

IMG_8425

Getting ready to head out. We have just unloaded from the vans.

We climbed out of the van with the rest of the group and started carefully going down a very steep hill that lasted for, what felt like forever, when in reality was just the rest of the day. While we were sliding down the hill, the group separated because some people went slower and some people went quicker. My parents had walkie talkies to keep in touch with my brothers who were ahead of us. When we dragged into the campsite we were exhausted. My mom was in charge of cooking dinner that night. She prepared the best spaghetti I had ever eaten. After dinner we looked up at the brilliant stars. Mom and I climbed into our cozy tent and fell asleep right away.

During the night mom got sick with diarrhea. “I’ll be okay,” she said. “Don’t worry about it.”

IMG_8571

Beautiful! Can you see us standing on the trail?

But as we went down the hill mom had to make many stops behind a bush. Mom saw the walk ahead and felt dizzy. We were considering going home, but mom kept going. David and I went ahead with a young couple, David and Ari. I had known Ari since the day I got to Peru. She worked in the hospital with my Dad. She was very funny and had a unique personality. Then she married my peruvian teacher, David. Peter and Sarah were a group, and Dad and Mom were a group. Mom and Dad were way behind. Dad was being patient and waiting for Mom while Mom was doing her business. The hike was super steep and we hiked non-stop. There were no flat parts at all. It was a very eventful day. When mom and dad finally got to the campsite, we had already eaten.The campsite was super cool. It had lots of wind, it was extremely high up, and it had an awesome view. It was a lot better than the other campsite.

IMG_8491

Dinner on the second night in a small restaurant. There are no roads to Choquequirao, and so all the provisions are brought up by mules for the people who live here.

We ate at a typical Peruvian house. We paid them some money and they brought us some food. It was cool because we got to see what it was like to live in a Peruvian house. There were guinea pigs running across the floor, and dirt walls. After that I took an extremely cold shower but it felt good. We went to bed exhausted. But I didn’t sleep very well because in the next tent they were playing games and being very loud, but I woke the next day refreshed and ready to go.

IMG_8517

The family looking over the ruins! For some reason Dad thought they were “awesome!”

We hiked the rest of the way to the Incan ruins. They were pretty cool but definitely not worth the hike. At least that’s what I thought. We ate our lunch there, a few granola bars and some fruit, and then started walking to the camp we stayed at the first day. It was miserable on the way down. I thought I broke my toe because it hurt so badly and I cried at one point. I rode a horse for about fifteen minutes and we were at the camp. Ari and David, that young couple me and David walked with the day before, were in charge of dinner. Basically we had raw rice and raw vegetables. They were not good cooks. I imagine they’ll get better at it. I mean they had only been married a couple months. When I went to use the restroom it was very disgusting. The toilets weren’t flushing so they were overflowing with brown and yellow. Mom went to go talk with the manager about the toilets. It took a while for them to fix it. We went to bed exasperated. That was definitely the hardest day yet.

For breakfast the next day we had granola bars, again. We were hiking up the hill that we went down the first day. Mom and Sarah were so worn out that they got on a horse together and were at the entrance in no time. David and Peter went ahead and so it was just Dad and me. I talked and talked all the way until we got to the entrance. Dad would be like “ I need to take a break Annie,” and I would say “Okay,” and we would stop. I wasn’t tired at all! I told dad about “The Ted Wars.” That was when I stole a stuffed animal named Ted from my brother David. He stole it back and then I stole it again and so on. I told him about my favorite part of the hike, about my friends, and practically everything I could think of! Right when we were walking up the final hill we saw two amazing condors soaring above us.

IMG_8561

Walking up the hill on our last day!

They were so close I felt as if I could touch them. It was an amazing experience. When we got to the entrance mom gave me some money to buy a snack. The car that was picking us up was very late. Something about peruvians you probably didn’t know is that peruvians are always very late. I ate my snack and talked to my teacher, David. When the car finally came I climbed in ready to get home. We all marveled at how we just did that long hike. I was glad to get home. But if someone invited me to go again, I would say yes.

We Chose This Too

We were stuck out on the lake for an extended period because a hippo came and hung out where we bring our boats ashore. He eventually moved on, but too late to avoid some pretty painful sunburns.