If you want to see what is going on at Rift Valley Academy where Allison works as missionary volunteer teacher, you can follow their Instagram account by clicking on the picture below. Our kids often make appearances as Annie does in this picture. Rift Valley Academy is a boarding school for missionary kids whose parents are working throughout Africa. All of the teachers are missionaries, supported by people and churches from their home countries. We are so glad that Allison gets to work there, and we are thankful for the school’s service to our own kid’s lives.
This is what it looks like in the middle of the night right before doing surgery on a woman with an ectopic pregnancy. This mother of three came to our hospital with severe lower abdominal pain, a very fast heart beat, and low blood pressure. When we examined her abdomen it was very tender in the lower pelvic region. We did a quick ultrasound confirming our suspicion that she had a ruptured ectopic pregnancy. This is a surgical emergency. I walked quickly to the operating rooms and woke up the surgical staff, but I could not find the anesthetist. It turns out he was trying to help revive a 28 week baby who had been born two days earlier. I found him because the pediatrician called as I was sitting the in the OR and asked me how a different, critical patient in the ICU was doing. This other patient was admitted for severe HELLP syndrome. This is basically a multi-organ failure during pregnancy resulting in anemia, liver failure, clotting failure, and in this patient’s case she had developed blood clots in her lungs. I said she was stable, asking why she would want to know. It turned out this unfortunate woman’s baby had died. My on call anesthesia tech had been helping try to resuscitate the baby. Ari (the pediatrician) wanted to assess how the mother was doing in the ICU before she let her know her baby had died. I ran up to ICU to check on her, and I watched as Ari in the most gentle manner shared the bad news of our sick patient’s baby’s death. I walked quickly back to the OR, scrubbed in and opened up the abdomen of our ectopic pregnancy patient. The pelvis overflowed with blood and clots, but with suction the uterus was seen and the large ectopic pregnancy (this is a pregnancy outside of the uterus) was seen in the area where the fallopian tube enters the uterus. We took care of the dead ectopically positioned pregnancy, started a transfusion for the mother, and then closed up. I went home only to be woken to the news that another patient had a severe perineal tear from her early morning delivery. Back to the hospital I rushed to sew up this bleeding tear in the operating room. Today I have a lighter load, doing lectures in the ICU. I am so glad, because it was a tiring night. Oh, and its my birthday! A great start to year number 49. Yes that means I am 48 years old today. I cannot believe it.
At Rift Valley Academy there are projects for each class to build unity as well as to serve the RVA community. One night is called Sophomore Restaurant. All the sophomores and their sponsors (we are some of them) work to plan a menu, advertise, arrange baby-sitting, and then it all comes together in one day while we cook, serve, clean, and entertain our RVA diners. I think it is the funnest thing we have done with the sophomores, and it was fun to watch them all work together to help one another and serve the RVA staff. Allison once again took on cooking responsibilities, and I helped run a small cafe next door that served those who were not able to get tickets to the main event. It was definitely an all day project.
Next year we get to be diners instead of servers! I am looking forward to being on the other side.
Karanja is one of my many excellent medical officer interns. He is a very good doctor,and I would trust him with my family. There are others like him, who have come to Kijabe after finishing medical school to do their first year of post-medical school graduation training which is referred to as an internship. This is a year of practicing medicine under the supervision of consultant / attending physicians. It is a system much like we use in the United States to be sure all of our medical school graduates transition from classwork to the practical work of actually caring for patients. I am privileged to serve as one of the consultant physicians at Kijabe, and truly the pleasure is all mine. It is a great blessing to work with these young doctors. Karanja is a good example, as he strives to become better at each skill placed in front of him. I am humbled by his and the others’ desire for knowledge. God is using Kijabe to train doctors for works of service throughout east Africa, and when I talk to these young men and women I am challenged by their ambition to show God’s love and compassion through their work and lives.
Another night of obstetrics call is in the books. It began with mother who was admitted with a femur fracture from a traffic accident. She was 31 weeks pregnant, and the baby’s heart tones were not completely normal. I watched her overnight as she was readied for surgery the following day. I imagined that her placenta would separate from the wall of her uterus due to the trauma, and I would have to rapidly take her back for a cesarean section; I wondered if I would need to call the orthopedic team to fix her fractured femur at the same time. Next was a severely ill pre-eclampsia (high blood pressure in pregnancy) patient. Her pregnancy already was complicated by severe growth restriction in the baby and loss of fluid around the baby both of which indicate that the placenta is failing. The estimated weight of the baby was about 2 pounds which indicated she was about a month behind where she should be. As I watched the heart tones of the baby they were minimally reactive indicating a unborn baby at the end of its rope. I took her for cesarean section and pulled out such a small little girl. She is doing well as of now on a ventilator, and I hope she makes it. The call ended with a delivery of twins right at midnight. The first came out normal looking for the exit. The second backed its way out in a breech position. The interesting thing is despite being twins, because of the timing of their birth, they have different birthdays. Cool!?