Driving on Small Rural Roads . . .

. . . you might be surprised when rounding a corner, come to a complete stop, and then grab your camera! I know this is just a normal thing for people who have grown up here, although even Kenyans generally get excited when they see the big animals up close. However for a kid from Oklahoma, these sightings are always exceptional.

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

What Should We Do This Weekend

Possibly some people wonder what a weekend in Kijabe is like. It is similar in to a weekend in the US, except that it is more relaxed. There are no organized sports or activities, no restaurants to eat at, and everyone we would want to see is within walking distance. If I am not on call, I will go in on Saturday morning and round on the week’s patients. Afterward, I turn my patients over to the on call physician for the weekend and I am free (sort of – it is hard to completely disengage from the hospital). The kids usually have school activities, but those have decreased significantly because of COVID precautions . . . which is a real bummer as we all agree. However most Friday and Saturday nights they have class activities up at school. If we have an occasion to go to Nairobi, we will make the hour drive to do grocery shopping or eat a nice meal. Pre-covid, we might go into the city to see a movie or go bowling. Sometimes we can go camping in one of the nearby national parks or we go to the lake that is an hour away to go sailing. If we stay in Kijabe (usually) we may build a fire in the pizza oven and have friends over for pizza as the sun sets. I go on long hikes in the forest and give the dogs a chance to run and chase monkeys. I work in the yard, Allison cooks something fun in the kitchen, I clean the storage container (a never ending process), and other odd jobs around the house are completed. Often we have friends over for coffee on the porch or we go to their place for the same. It really is a good life. So what should we do this weekend? We’ll figure out something.

Visit Us and Go on Safari!

I have wondered what it might take for more people to come to visit Kenya and Kijabe. Maybe when the pandemic is over you will get a call from me inviting you personally to see what is going on. I recognized that personal invitations instead of generalized invites apply more pressure, and I have been hesitant in the past to do so. But I feel like there are things to see and understand that cannot be known via blog or stories. So this is one last general invitation (ok, probably not the last), and then you can wonder if I will send a personal invite. Or maybe I will decide that I do not want to pressure anyone. It may depend on the mood. However, if you do come, besides seeing the good work of Kijabe Mission Hospital and Rift Valley Academy, we might be able to hook you up with other good projects going on near us. And even more, you can go on safari. We have been on three safaris since moving to Kenya. They are quite the experience. Here are some highlights.

Sunday Night in Kijabe

Some random thoughts this morning. Most often we attend a small group Bible study on Sunday nights. This week we hosted at our place. It is a nice time to relax and enjoy other’s company. It is a good time to pray corporately. Almost always it is part of making new friendships in the transient world of a missionary community. We miss friends back home . . . did you know we have been living outside the US for almost 9 years! It has felt short and long. Our kids were small when we left, and now we send our oldest off to college next year at Abilene Christian University. Time really does fly as they say. It is sad to see him go, especially after such a bummer year with the COVID restrictions. On the other hand I am really happy for him. ACU is a blast, or at least it was. I hope it continues to be so. In the picture below are several of our Kijabe friends. One couple runs an organization committed to environmental protection while encouraging productive farming. Another teaches at the local seminary. Another is helping to establish small clinics in the poorest communities of Kenya. Another is an anesthesiologist at the hospital. There is a lot of good work being done!

Lockdown Shutdown

Many of you know we have been in a governmental lockdown for the last month. We are over one year into a curfew. Schools have been closed for the past month, and mostly closed for the past year. We did not know if our kids were going to finish school online or in person. We were praying for in person. Today we got notification that everything is open again!. For us this means freedom of movement through all of Kenya. The lockdown spoilt a vacation we had planned for early April, but at least we now have flight vouchers for an obscure regional Kenyan airline. Maybe we can use those next Christmas to go to the coast? Instead we did a trip I have been wanting to do for four years to Amboseli National Park which happened to be within the region we were allowed to travel. Amboseli is a beauty. There were not so many animals as hoped, but the setting made up for it. So although it was no the trip to the beach we had hoped for, it was a nice respite nonetheless.

It took us hours, but we finally found some elephants. This was a bit disappointing because usually there are hundreds, and even thousands of elephants at Amboseli.
The magnificent Kilimanjaro!
Looking good!
A cup of java on the savannah. The good life!

Help Our Friend Isaac

This is a long story, and so let me cut to the chase. We are trying to raise 6000 USD for our friend Isaac. He is a man who is trying to break a cycle of poverty and family abuse while providing for his wife and three children. If you can help us raise this support we will likely influence generations as he will be able to support himself well enough to send his kids to better schools and possibly even university education. This is straight charity with no tax breaks and no hope of payback, but he is our Christian brother in need. Maybe and hopefully this will have one of the greatest impacts of any of the work we have done in Africa and Peru. Or it could all fail, but not every Christian act of kindness produces fruit we can see. But it all is used by God for his purpose. Read Isaac’s story below.


To give, please contact me directly at wcaire@gmail.com or WhatsApp me at +254 700 895 116. We are in great need help for Isaac by the middle of April. Support for this will not be going through our mission agency as it does not technically fit our mission’s goals.


This is a very brief summary. I am happy to give more details in private. Around 18 months ago Isaac’s house that he had built on his family’s property washed away in a flood. At that time a friend of mine who does community development came to Isaac to discuss a project for farming in the valley. It seemed a like a good new start for him, and Isaac was naturally excited. Unfortunately the COVID epidemic messed up those plans, and the man who was the driving force behind this community development has returned to the US. Meanwhile due to bad family dynamics including physical abuse of his wife by his family, Isaac had to leave his family and find a new place to live. He has moved from place to place over the past year trying to find a place his wife can be safe from his parents and sisters. Finally in his eagerness to try and provide for his family he has overextended himself financially, and he needs to be rescued from losing land that he has purchased to try and better his life, support his family, and provide education and way out of for his children. This is a rescue plan for Isaac, and I need your help. I have been employing Isaac since the day I arrived in Kenya. He was almost the first Kenyan I met, and he has worked for me 3 days a week since that time. He is industrious – in fact in the 6 weeks he has had his land he has planted crops, built a house, planted a hedgerow, dug a 35 foot pit latrine, and installed a water tank. I do not believe our generosity will be wasted. However he needs our help. 6000 USD is not much for a bunch of Americans working together. For Isaac that is 6 years salary. Please help me help him if you can. Please email me for more details of why he is in this situation and how to send money to help. Thank you.

A Day in the Life . . . Friday in the ICU

I walked the long way into work (its not long really) because we have closed off all but two entrances into the hospital so that all can be temperature screened before entering. It is nice to enjoy the very brisk morning air, watch the monkeys, and listen to a podcast.

8:30 AM     Time for the weekly audit of mortalities and close calls on the internal medicine service. This week a lot of time was spent discussing the COVID ward and some ICU complications from the past week. At the end I got a nice despedida with a coffee mug that I had been hoping to get with the Kijabe Hospital logo.

10:00 AM     Rounds in the ICU. In the last 2 days we have added 8 new patients. Yesterday was worse when I had six new patients in the span of just a few hours. Today it is just two new patients. Severe hyponatremia, a patient with a adrenalectomy in whom we have to closely watch the potassium and blood pressure, a myasthenia gravis with mucus plugging causing one lung to not function well (she got a tracheostomy yesterday), a traffic accident with a broken hip and ribs, status epilepticus, sepsis in a patient with esophageal cancer, another who has had her right shoulder and arm removed for cancer complications, severe diabetic ketoacidosis and sepsis . . . the list goes on!

12:30     Time to do some record keeping of the patient for the last week so that we have good records of what they presented with, how they did, how long they were in the hospital. We do this to see trends in our care and illness and improve quality over time.

2:00     No lunch today. It made me wish I had eaten breakfast. The coffee from the morning was serving me well. Time to teach EKG reading to my trainees. One is an orthopedic resident. The other is a medical intern (1st year out of medical school). They have been with me all week on the ICU service.

3:30    Afternoon rounds on all the patients from the morning to see how they have progressed. Everyone seems to be ok, although many are still sick. Several are well enough to leave the ICU.

4:15     I get a call from one of my ECCCOs (ICU clinical officer) stating there is a problem in one of the HDU (like an ICU but without a ventilator). One of the surgical patients we have been rounding on who had major spinal surgery now has a heart rate of 200! This is new to us. An EKG is ordered. She is stable, and I take the moment of getting the EKG to take Dr. Steve on rounds of all the patient in the ICU service. Steve is on call tonight, and I confess I am relieved that he can take the lead on dealing with the tachycardic patient. Is it a sinus tachycardia or atrial fibrillation with rapid ventricular response. Hopefully the EKG give him some clues.

5:00    Steve is in charge. I leave notes on all the patients for the weekend coverage doctor, and head home to start packing for my flight on Saturday. A pretty full day for my final ICU day for awhile.

Being at Kijabe has to be one of the best jobs in the world!

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Our Internal Medicine team after morning audit.

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Passing Head of Department duties happily off to Dr. Tony

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Friday Morning Internal Medicine Audit

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Teaching EKGs

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Another Plague – Seriously, What is Next?!

Porch Picnic

We had around a 3 week break in the rainy season, which has now come back with a vengeance. It is cold for Kijabe. That means a fire every day to warm the house, space heaters in the bedrooms, and nights huddled around the fireplace in camping chairs to stay warm. I miss the warmer nights (we were still in sweatshirts) of our mini dry spell with dinners on the porch.

Nights eating dinner on the porch are the best!