David Nawrocki at Maseno, Kenya - Chapter 4

Chapter 4   My Fellow Medical Volunteers   During my short time here, I spend each day with two other health care volunteers, Dan and Helen. Together, the three of us work with Dr. Hardison caring daily for the patients seven days a week at Maseno Mission Hospital .  We also sing together (off key albeit), pray together, hike together, and take our meals together.   Dan is a resident physician at University of Tennessee in Memphis , TN.  He is 28 years old.  We celebrated his birthday this past Wednesday.  Dan was born in Chicago , Illinois .  He lived in Chicago for 16years then moved to Georgia and now Tennessee where he currently resides.  Dan is a skilled clinician as well as a brilliant computer software/hardware guru.  He loves technology and has helped remove viruses from our laptop computers for the three of us as we have attempted to journal each day.  He has a dry sense of humor and loves to make people laugh.  His body mass index is slightly elevated.  He announced the first day here he was here the he was probably the fattest white person in Maseno.  Once he had established himself, he was able to get down to work as a volunteer.   Helen is a fourth year medical student who is completing a medical rotation here at Maseno in community health.  Her full name is Helen Shi Stafford.  Helen was born in mainland China and moved to the U.S. when she was two years old.  Her parents are both medical physicists who came to the U.S. to further their education.  Helen lived much of her life in Oklahoma before moving to San Diego , California to attend medical school.  She is married to Chase Stafford who works for an organization called "Worldvision".  Chase travels to underdeveloped countries where he establishes organizations that can design and build infrastructure projects for developing countries.  Helen and Chase have been married for approximately two years.  Helen is a boundless bundle of energy that engages with everyone that crosses her path.  She is also the volunteer who has been here the longest (by one week) and has been the orientation guide for both Dan and myself.   Cycles   The are many cycles that play themselves out every day at Maseno.  We have had four pediatric admissions this past week to the hospital.  Two were for malaria and two for malnutrition and possible pneumonia.  Malaria is endemic in this part of Africa .  People of all ages come to be treated for signs of symptoms of malaria.  The government provides chemically treated mosquito nets for its population however they do not provide or help pay for the malaria medication that is required to manage the disease.   Francis, one of the clinical officers here at the hospital explained that as the rainy seasons change in Kenya with the time of the year, so do the increases in malaria rates change.  The incidence of malaria is directly related to the presence of standing water on the land.  Malaria rates go down during the dry season because there is no standing water for mosquitoes to breed in.   As the land becomes parched with the advent of the dry season, water can only be found near the riverbeds.  As the animals migrate towards the last evidence of water and the riverbeds, the footprints they leave in the earth create small pools of water that breed mosquitoes before the water eventually dries up.  The health ministry has demonstrated through studies that they can predict the increased levels of malaria in nomadic populations according to the migration of animals they follow with the gradual disappearance of water on the land.  Eventually the water dries up and rates of malaria temporarily drop until the next rainy season.   As the sun dictates the cycles of life in Kenya , it rises and falls every day at the same time since we live at the equator.  The sun rises at 6:00 AM every day and sets at 6:30 PM every day.  The sunrise and sunset occurs very rapidly given our geographic location.  One evening we had hiked four kilometers from the hospital compound.  We began to make our return journey after sunset thinking we still had enough time before darkness fell.  We found ourselves racing back to the hospital compound to reach the safety of its gates.    The temperature rises and falls consistently every day.  It is cool in the morning and then becomes oppressively hot by 12:00 PM .  The temperature then begins to cool off in the afternoon.  There is a wonderful tropical breeze that returns every evening that blows across the land.  Then of course, there are the evening rains that bring the life giving water back to the land.   My favorite cycle is the afternoon return of the juvenile monkeys near the outpatient clinic.  They appear each day in the afternoon to entertain and joyfully play in the trees between the hospital wards and the outdoor clinic area.  We have a mother/infant pair that travel amongst the mayhem of the juvenile playtime.  She lets her infant play with the older juveniles, always with arms length of pulling him/her back.  One evening I sat on a bench under a tree outside the hospital ward with a 12 year old boy named Thomas who was hospitalized for an acute attack of juvenile arthritis.  We talked about his aspirations to become an engineer as the monkeys came cautiously towards us while we fed them coconut cookies.  Thomas and I eventually went out separate ways for dinner.  The monkeys remained on the roof of the clinic quietly contemplating the sunset and their choice for a resting place for their sleep in the trees that night.   There is a cycle of patients that come to the Maseno Mission Hospital according to the visitation of health care professionals.  One patient told me that she walked several miles to come to Maseno because she heard that there were "mzungu" white people here.  When the mzungu people leave, patient counts drop slightly until the next "mzungu" visitors arrive.   Monday through Friday we begin the day with our Spiritual Devotional Service.  There is an assistant pastor that always goes through the hospital wards first thing in the morning praying for the patients that are hospitalized.  This week, one sermon referenced the writings from the Book of Revelation.  One of our nursing students gave the sermon.  She asked us if we would recognize the face of God if God knocked at our door?  Would we recognize the face of God in the faces of our patients if God knocked at our door?   Once the service ended, we left the chapel and began our morning rounds.  The night before a patient had been admitted to the hospital with complications from HIV/AIDS.  As we approached his bed we realized that he had passed away shortly after the end of our morning Spiritual Devotional Service.  I found the words of our morning service present in my mind as I helped carry his body from the hospital ward to the morgue where the family would comes to claim his body and take it home to bury with his relatives on their family plot.  We carried the body pass an outdoor area where HIV positive patients were awaiting counseling and access to their medications.  Patients sitting in the outdoor waiting area knew that we were carrying the body of someone who lost their battle with HIV/AIDS.  We all found ourselves asking if we would know the face of God if He knocked at our door.   The cycle of life plays itself out in many ways at Maseno every day.  Faith plays a pivotal role in the lives of people here where medicine can no longer fulfill the need.  Many of the staff at Maseno Mission Hospital are HIV positive yet they live in fellowship to serve the needs of people who attempt to survive the disease.  I cannot tell you the number of people that have asked us to pray for them as we return to America .   The Reverend James Obura   The Reverend James Obura is the chaplain for Maseno Mission Hospital .  He is a rugged glowing man with curly silver/gray hair who dresses in an unpretentious green tattered robe and leads us in spiritual worship at the devotional service every morning.  James (as he likes to be called) is in his 80's and can probably still run a full marathon.  He leads us in worship, song, and praise.  He teaches us Swahili each day.  We say the Apostles Creed, the 23rd Psalm and the Lord's Prayer each morning in Swahili with his guidance, patience, and prayer.  He always prays for us each morning before we leave for the hospital; wards and prays that the patients we touch are filled with faith and hope.    James lives on top of a mountain behind Maseno Mission Hospital that has been in his family for generations.  Standing in his front yard you have a commanding view of Lake Victoria that fills the entire horizon as if you were looking out over an ocean.  James told us that when he was a boy, his land was home to dozens of wild leopards that roamed the countryside and the hilltops.  He was taught as a boy never to run from a leopard if you were approached.  He was told to pick up a rock and throw it in the direction of the leopard.  The leopards would realize that you were not afraid of them and would give you quarter so that each of you might go your separate way.  Kenyans who are diagnosed with HIV make a decision each day whether they are going to fight the disease or give up and die.  Kenyans face their leopards each day with their disease.  Their faith is their rock which helps them move forward out of fear and back into life.   Times have now changed.  The leopards are gone but the land still provides for James and his extended family.  It is a refuge for prayer, meditation, solitude and the home of his family burial plot.   James recently lost a daughter named Helen.  James and his wife now take care of Helen's children since her death.  Helen is also the name of the fourth year medical student who is volunteering here with us.  James fell in love with Helen when he first met her because she reminded him of his lost daughter with the same name.  He recently invited Helen to his home for dinner with the opportunity to meet the rest of his family.  James and his wife had seven children.  Six currently survive.  During the family dinner, Helen had the chance to meet all of them.   After dinner, Helen walked the land of James ' ancestors with him.  They sat in the late afternoon shade and discussed Helen's aspirations to work as a physician in developing countries as well as James' aspirations for never leaving his ancestor's mountaintop land in Maseno.  At the end of the day, two of James' sons gave a had written note to Helen when she was leaving which read as follows:   To Our Guest   First Born: Dishon Mahoma Obura Second Born: Patric Lumumba Obura Box 116 Maseno , Kenya   Madam:             We kindly request you when you go home, please remember us. We have HIV and we are on drugs therefore, we humbly request you to support us in prayer that we are able to start our project (crops while we are still alive to feed our families).   Yours faithfully, Dishon and Patric, Sons to Mr. James Obura   Christ's Hope   There is a man named Desmond from Northern Ireland who lives in Kisumu (2nd largest city in Kenya bordering Maseno). He works for an organization called Christ's Hope.  Desmond is one of several people who scour the townships of Maseno and Luanda looking for HIV positive people who have been abandoned by their families and require health care.  He brings them to Maseno Mission Hospital where they are cared for and nursed back to health. Desmond recently brought us a man named Jerrod who was wandering in the streets with shortness of breath, malnutrition and fever.  When Jerrod arrived at the hospital, he was listless and struggling to breathe with pain in his chest.  He was diagnosed with tuberculosis and placed on medication, fluids and food.  His ability to breathe without pain gradually came back, his smile returned and he left the clinic with Desmond to return to his community.    Prayers for the People of Maseno   As Helen, Dan and myself prepare to leave Maseno Mission Hospital this week, we are continually asked by patients, family members and hospital staff to keep them in our prayers as we prepare to return home to America .  I ask you to keep them in your prayers this Sunday and in the weeks to come.