At Last Will is Going Too!

Today I fly to Kenya! Getting back home did not go as smoothly as hoped, but at last it is happening. Wednesday I went for my COVID test to be cleared to fly, and it came back inconclusive. What!!! That same day I got my second dose of the Moderna vaccine. And so yesterday I was up early to try and get another COVID test, but was also noticing that I felt a bit feverish and chilled. I knew this could be a side affect of the vaccine . . . I have heard that even some people get chills to the point of shakes. However, since I had an inconclusive test the day before, I was imagining that at last I was possibly coming down with COVID the day before I was scheduled to fly to Kenya. I will add that despite the fact that I felt a bit funky, I could have pushed through it without concern if not for the inconclusive test and the possible delay of my flight making me imagine worse outcomes. So I went back to the lab to get my test, and they told me their internet was down. Uh oh! Time to scramble to find another testing sight. Luckily there is an ER that will do the test for $450!! dollars with results in a couple hours. I drove over there quickly, and got my test. Negative! So I went to bed early last night after taking some Nyquil, and I feel better this morning, if not perfect. However, no fever or chills. I am off to the airport in an hour or so for the long flight and travel to Kijabe! I am glad to be going home, and I am glad to see my family soon. It has been too long!

At last . . .

Today, after multiple attempts, Allison and the kids flew out to Dallas toward Nairobi. Allison received her tourist visa this morning, and so we got up early and had the tickets changed and put everyone but me on a plane today at 3PM. I am so glad for them. It allows them to avoid sitting in a 2 week quarantine in Kijabe before they could attend school in person. So tomorrow around noon our time in Dallas, Allison and the kids should be landing in Nairobi. Yeah!

Ready for takeoff

It Didn’t Happen

We went to the airport today so Allison and the kids could fly to Kenya. When we arrived with our 17 bags to check, 5 backpacks and 5 carry ons (whew!) we were informed that London had new entry requirements (COVID safe traveler forms). OK. No big deal. We rapidly filled that out as we stood in line the second time (we were sent to the back of the line to fill those forms out). At the counter again we were asked if we had the Kenya safe traveler forms done. No we hadn’t because we did not have the seat numbers for our flights into London. We could not get them electronically, and had to get them at the airport. The forms required seat numbers. She told us you could put in any made up seat number. Uhhh. OK will do. We did that quickly, but the bar codes that were supposed to be generated were not coming onto the iPhone despite trying several different browsers. Shoot! That is going to be a problem. Or maybe not since there is possibly a bigger issue at play. According to the ticket agent something looks wrong with Allison’s work permit. They don’t like the look of it. (Keep in mind that this is the same document that we have been using to travel in and out of Kenya for the last 3 years without issue.) Now what . . . maybe if we could get an electronic tourist visa quickly, we can still make it? Oh wait those need a formal invitation to Kenya as well as other documents we don’t have.

Eventually time ran out. We called for our rides to come pick us back up and drove somberly and disappointedly home.

Time to try again in a couple days, but that means repeating all of our COVID tests! Darn! This will be number four for Annie in the last 2 weeks. Forgot to mention that her name was misspelled on one that was done earlier this week, so it had to be repeated.

And They are Off – Tomorrow

All tests came back normal in regards to COVID. Everyone is negative. So Allison and the kids fly out tomorrow for Kenya. Everyone is looking forward to arriving in Kenya if not the trip. I am staying for a little longer. I will try and work some, spend some time with friends, and then will fly out at the end of the month after I get another dose of vaccine. So things are looking up again in the Caire household, and life in Kenya will soon be back to normal.

Leaving Soon!

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We leave on Monday for Kenya. Before then we have to move our household goods to storage, celebrate Christmas with two families, pack up around 18 checked bags plus a carry-on and a backpack for each of us. OUCH!  Packing up to go home from our other home is very weird. Sarah, who has never really gone to school in the US is always eager to get back to Kenya or Peru. Peter who loves his garden and projects, is also glad to go home. Annie loves people and experiences, and so while glad to go home, her feelings are mixed as she leaves the people and experiences she is having here. David loves living in the US and he loves having the freedom of a car and a license. He is less glad to go to back to Kenya, but he is looking forward to seeing some of his friends again. Allison loves teaching in person. She will be glad to be back in the classroom at RVA with her students face to face. I am glad to be going back as well. I look forward to seeing our residents and medical officers that we teach in the hospital. I look forward to good weather with long hikes to unwind. I like the medical missionary life!

Please pray for us in these last three stressful days of packing and saying goodbye. Please pray that we will do good work in Kenya. Please pray that we will all adjust well to life again back at our other home. Please pray for our finances as well. Thank you for reading and being a part of it all! God bless you this Christmas and in the New Year!

Sadness During July

The following video is full of happiness and “good times”. I think it best represents an effort to try and chase away feelings of sadness and guilt about not being in Kijabe. Coming to the USA is a mixed bag. It is home and I really love being here. Everything is known, comfortable and easy. It is the place where I feel normal. I will appear to be and truthfully will be happy when you see me. However, when I see pictures of friends working in Kijabe, when I get their messages through Whatsapp, when I hear the struggles and victories, I get sad and even jealous. There is great work going on there that is full of purpose! I have a sense of what it is like for many of our friends who have left Kijabe and Peru permanently although they did not wish to do so. I am sure every time they see pictures of friends back in Kenya, it is a mixed bag of emotions. The mission was where the work was, home is where the comfort lies.

We are home for a little while, and hopefully we will be back to Kijabe at the end of the year. Please pray that Rift Valley Academy will open as planned in January. Please pray that some needs for our kids will be met while we are here in Texas. Please pray for Allison as she continues to teach at RVA online. Our girls will continue to take classes from RVA. Our boys will enter the local public school. Please pray that I will get a some work locally that will both give me a sense of purpose and also supplement our salaries. The US dollar goes a lot farther in Kenya than in the US. Thank you for partnering with us, and as COVID allows, lets try and see one another.

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It has been a crazy great month

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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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Prayer Requests

We are just a few hours from getting on our plane. Could you pray for these things.

  1. Safe travel with smooth connections, no lost luggage, and family sanity.
  2. Work for Will in the US to help pay the bills. Our mission salary is good in Kenya, and not enough in the USA. Fortunately, I have usually been able to get work when home, and I pray that I will be able to do so again.
  3. Wise decision regarding school for the kids. Public vs. private vs. RVA online. We suspect it may be a combination of the above. In addition lets all pray that somehow school will be as normal as possible for all kids in the US!
  4. The kids still have 2 weeks of online school left. Focus!!

Why is RVA Closed and We Fly Tomorrow

As of this writing, Kenya has all schools closed at all levels. Our hospital does not have its nursing school open. Medical schools are closed in the country along with theological schools, high schools, universities, and grade schools. Even most training programs are shut down, which means many of our Kijabe students in advanced areas such as anesthesia and critical care are not in classes. We still have our interns, but we cannot do large classes with them. So with all of that stopped, it is not a surprise that Rift Valley

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The chaos and pain of packing!

Academy is closed as well. Our next term does not start until the very end of August, so you could propose that there is a chance it could possibly be open in the fall if the government changes its rules. However, schools are not scheduled to restart until September at the earliest, and then only in stages. And there is word that boarding schools may be some of the last to open. RVA is basically in an all or nothing situation. We open all the way with all or our grades and students, or we offer online classes. There is not the staffing to do it any other way. And so the school had to close for the fall. We are praying for the Spring. I want to get back to the hospital, and David, as a Senior next year, wants to be a graduate of RVA. Allison wants to teach her students in person, and the others want to see their friends and be back to their normal lives which are here in Kijabe.

We fly home tomorrow. I have been working in the ICU all week and Allison has been working on her online teaching and department evaluations. The kids are still in school because RVA does not end classes until mid July. So there is a lot of packing that has to happen tonight to prepare for a 6 month visit to the US! We are looking forward to being home for an unexpectedly long period of time. It gives David more chances to visit some colleges. Maybe the kids can be in marching bands (is that even possibly going to happen)? We can see our parents, grandparents, and cousins. We can happily see our friends! Maybe I can go snow skiing! Maybe Allison can do BSF in person? There is lots to look forward to even as we try to not look behind too much.