Evocative (adj.) - bringing strong images, memories, or feelings to mind

Karibu!
That means welcome in Swahili. 
To start off, thank you for reading this.  This is my attempt to put my trip to Kenya in words and pictures.  

Psalm 60:3 "You have made your people see hard things."  

Twende.  That means - Let's go.  

As long as I can remember I've wanted to go to Africa.  The night before I left I had received several emails about safety from the US Embassy.  I would be lying if I said I wasn't nervous.  I laid on my Queen size bed on clean white sheets for the last time for 3 weeks contemplating the unknown.  All I knew was my heart was restless and that this trip would be difficult, but good, like most good things are.

The first thing most people ask me about Kenya is Did you ever feel unsafe?  And my answer every time is absolutely not.  In fact, I never felt more welcomed and loved in any place before.  I want to convince you that despite what the news tells us about how Africa is wracked with death, disease and destruction, indeed it is, there is unimaginable hope and joy waiting to be discovered if you look hard enough.  

I was welcomed to Kenya with a broken into bag that could no longer close and airport personnel that really didn't care. After traveling for 24 straight hours, I have to admit my level of care was at an all time low.  I tried to focus on things that truly mattered, like wifi at our guest house. The first day, all I knew was I was always tired and hungry and I wasn't sure which one was causing the other.  

I've been to third world countries before.  When the first child asked me for money and I had to say no, I don't think it hurt me as much. I'd done that before.  I knew the money would only go to the parents or drugs. I've seen severe poverty before. But something was different here and I couldn't put my finger on it. There are 42 tribes each with their own language, culture and traditions.  And that is something beautiful. 

We spent the first day with orphaned baby elephants, hand feeding giraffes and eating at a nice restaurant.  I loved seeing the animals, it honestly just made me smile. I ate something with just vegetables because I wasn't confident about meat yet.  I hoped for a hot shower later, never hope for a hot shower. But there was water, which I would soon learn was precious and wasting it is basically a crime.

I have a bad habit of instantly falling in love with places until something shatters my idealistic perception of them. I started off not very in love with Africa. From stomach issues, damaged luggage, cold showers, to not being allowed outside at night it wasn't looking very favorable. I hoped time would change that. The first night in Nairobi I laid underneath my stuffy mosquito net and I could hear men yelling and cars screeching outside my window. And the softest sound of a bird, probably trying to tell me Africa can be beautiful if you look and listen. 

                               Heshima means dignity.  

Children with disabilities in Kenya are seen as cursed from God.  Mothers must choose between their families/marriages and their child.   

The next day we visited Heshima Center for disabled children.  It's one of the most beautiful places I've ever seen.  They employ every mother and their child comes to the center for physical therapy, occupational therapy, speech therapy and school lessons.

Many had cerebral palsy, were on the autism spectrum and had lasting effects from meningitis.  The mothers make jewelry, sew and work around the center cooking and cleaning.  I learned so much from this place it's difficult to know where to start.

Here I learned that this country is corrupt.  Policemen take bribes. You are shunned from your family if your child is disabled.  You are shunned from your community if they find out you are HIV+.  Community is everything here.  Women still have to have sex with their husbands if their husband is HIV+, which their husband acquired from their multiple girlfriends.  Polygamy is legal and common.  Husbands leave their wives when their child is disabled because it is "too much." 

You can't get healthcare or medicine without paying up front.  I thought long and hard about this. Whether this was good and what it would look like in the U.S.  The U.S. has plenty of its own healthcare issues.  I imagine that if this was how the US healthcare was run, there would be much less ER visits used like a doctor's office.  But on the other hand, there would be much more hurt and pain. The mothers told us that if you have to get a C-section, they go ahead and do the procedure, but you have to pay after.  If you can't pay, you have to stay at the hospital and work until you can pay.  Otherwise, no money means no medicine.  

 I saw a lot of hurt and pain in the mother's eyes and words.  When they talked about how they've been mistreated, abandoned and cannot go to the police for anything without money.  But then I saw pure joy when we asked them about their children.  I saw joy and happiness in the children's faces when laughing, playing together and doing simple tasks.  

It was exhausting for sure, any child with special needs is.  Heck, any child is.  But then I imagine what it must be like for the mothers.  I get to leave in the afternoon and go shopping like the consumerist Westerner that I am. They do not.  They can't push wheelchairs or strollers in the slums because of uneven roads and glass.  They don't have equipment for their child who cannot sit up on their own.  

I'm sad and angry about the hurt these mothers have endured.  

But I'm hopeful because places like Heshima exist.  I wish 1,000 more places like it existed. 

Click to learn more about Heshima 

The next day was quite the adventure.  We traveled to Masai land outside of Narok.  It was an extremely bumpy ride, dusty, and a foreshadowing of safari. I'll never forget the first time we left the paved road far behind us. 

My first impression was this culture is so beautiful.  There is so much to tell about this place.  

Dr. Tanya started the New Frontiers Medical Clinic and I'm not going to lie, she is a very intimidating woman (I hope she reads this and laughs).  She runs a tight ship/clinic.  In the mara we were surrounded by wild life, in the bush as it's called. There are natural fences around us to prevent wild animals from entering the compound (apparently there was an incident with a lion under the sink). There are no flushing toilets or showers.  I quickly learned not showering in Africa is very different from not showering in the U.S.  Lots of wonderful and interesting aromas. 

In the Masai tribe, greetings are everything.  You must say "sopa" to the eldest in a group and bow your head so the elder can touch it. And a sea of children run up to you expectantly waiting for you to tap them on the head.  

The houses here are called manyattas, which are made out of sticks, mud and dung.  And I slept in one.  It really wasn't that bad, even though I didn't sleep much.  I had a mosquito net, but I heard bug noises all night like they were crawling above me.  I also heard hyenas, which sounded very close. But that is how the Masai live. I'm glad I did it.

The first day I did child physicals in a primary school near the Empaash medical center.  That was terrifying at first.  I had no idea what I was doing.  I had a translator, there were a lot of flies and the children were very beautiful. Children are children no matter if they're dirty and have flies all over them.  My professors were there the whole time and helped me along the way, thank goodness. 

They say do one thing every day that scares you.  I slept in a manyatta and gave countless child physicals from another culture and language and wasn't completely terrible at it.  All in the first 24 hours.  

During the day at the school, the children wore their traditional Masai garb and performed a folk song and dance with the mountains in the background.  I don't get emotional very easily, but I was tearing up.  It was the most beautiful thing I've ever seen.  

The Masai women served us chai back at the clinic, which is a huge honor. And I saw zebras on the side of road while driving. What a day.  

The Masai tribe is so interesting to me.  They have gauged ears, long blankets, intricate beading around their necks and ears and walk with sticks.  They sometimes have their front and bottom teeth missing, which was done long ago due to tetanus so they could be fed.  Now it has become an aesthetic thing to do.  It's interesting how much aesthetics change by culture.  

The women mainly take care of the children while men do their manly things.  Later that day, we walked up to the small village where you can charge your phone and get a soda for 100 ksh, or about $1.  You leave your phone and go back later to pick it up.

The first night I made my bed inside instead of the manyatta a humongous spider crawled out of my mosquito net.  So there's that. 

At this point, Kenya was pushing me outside of my comfort zone in ways I didn't even know.  Here I was sleeping in the mara in a spider infested mosquito net, writing by the light of a flashlight and not showering or flushing toilets.  It was in these moments I realized I was serving a beautiful culture.  These are not poor people.  These people are rich in spirit and life.  We Americans are the poor people, weak in spirit and surrounded by crap we don't need that doesn't make us happy.  

My advice for anyone who feels sad or unhappy - go to Africa, stay in the Masai mara and go outside and stare at the stars and listen to the animals. 

At this point in the trip, people started to get some stomach bugs and issues. So that made me a little nervous.  But my priority at the time was spiders in my mosquito net.
Which is worse - spider bites or malaria? I thought about this for a good while, but I decided malaria was worse. So I still used my net.     

I learned some difficult things in the Masai mara.  Males are circumcised when they are older with no anesthetics, only a knife.  Only males can attend a circumcision. If the boy flinches or shows that he is experiencing any pain, he is mocked, everyone runs away, and he can never really recover from that in the community.  Female genital mutilation is illegal in every country, but still practiced widely.  A woman reported her husband for doing this practice in the Masai mara and she mysteriously died a few days later.  She was murdered.  A woman came into the clinic because she was sick and turns out she was HIV+.  She acquired it from her husband who got it from one of his multiple partners.  Of course, the first thing you think in healthcare is you must tell the husband.  But with the Masai, if a woman tells her husband she is HIV+ she will be beaten and thrown out of the community.  It is a death sentence to tell your husband, there is no where for a woman to work outside of the community and her children would starve.  Even so, the Masai male doctor still wanted to tell the husband.  So, Dr. Tanya told him that they would take part of his salary to support the woman and her children when she was forced to leave the community.  This horrified the doctor. So the woman will be receiving her ARV's (treatment for HIV) in secret and the husband will not be told.  

Dr. Tanya is truly an inspiration.  It's not easy being a female doctor in a male dominated culture.  In a culture where if a cow and a woman were drowning in a river, they would save the cow.  I am encouraged by all the hard work she is doing and how she works fearlessly and passionately with many teams to provide the best care possible. 

The next day I worked in a nearby school and did blood type testing, which involves pricking fingers and adding reagents to see if they are A, B, AB, O positive or negative.  One girl was AB+ and she looked terrified when we told her.  She heard positive and thought it meant HIV+ so we explained to her what it meant.  It broke my heart.  


I met the sweetest girl named Sarah.  She spoke wonderful english and said she wants to be a doctor.  She didn't hesitate to grab my hand and pull me along to see the Masai dance.  

She told me my hair was "smart" which means cool or pretty.  This is day 3 without a shower. It was crazy to think that even though we are worlds apart, we share the same name.  It was God's purpose for me to be born in America and for Sarah to be born in Kenya.  And it was His purpose for us to meet that day, share smiles, laughs and hear about her dreams.  I know God has a plan for Sarah and each one of those precious children.

In the evening we walked in the Masai market, stuck out like a sore thumb as usual but I loved seeing everything.  They were selling food, clothes, shoes, beads etc.  We almost didn't go because a fight broke out earlier that day.  The mothers broke all the liquor bottles at market because the men were using their money to drink instead of providing for their  family.  Go them.  We were able to go in an actual manyatta, it slept 7 or 8.  The windows were the size of my fist and I understood why respiratory issues are so common.  There's no where for the smoke from cooking to leave the manyatta.  

Walking back to the compound, a group of school children came and sang to us.  I'm seeing a trend of all Kenyan children singing, and I'm a fan.   

I was changing and learning so much in the bush.  I was fond of the dirt underneath my fingernails. It meant I held children that day and worked hard. 

I stopped looking for spiders near my bed because if they were there, I didn't want to find them.  But it was important to shake out the toilet paper roll and pick up the toilet seat, just to make sure.  I will never be able to dance like a Masai woman, but I did try.  

I looked forward to meals of rice, goat, cabbage, beans, spinach, and bread.  My favorite afternoon there I held Abigail and helped a young girl with her reading and writing in english. 

One night, Julius told us the story of how he became a man and killed three lions.  The man has killed lions and I'm scared of spiders in my bed, get it together.  He is basically the man, a community leader.  He chose to have one wife because in his words "it was enough."  He has 7 kids, 6 boys and 1 girl.  He has, what we would consider, Westernized dreams for his children. He wants to send them to university, give them an education and let them become whatever they want to be.  He told lots of other stories, like how he had to steal cows to marry his wife and men died because of it. 
Julius said that night - Welcome, you are home.  And I truly believe that. 

We saw 222 kids in 3 days. After the first day of assessments I learned enough words to basically do physicals without an interpreter. 

Our last night, Dr. Tanya encouraged us to not lose our compassion.  It's a balance of being tough, but not so tough you lose your softness.  And she believes in us.  I've never had a physician say that to me before.    

Lord willing, I will be back there.  This was another home, another family, another place I left my heart.  It hurt to leave, but I am keeping this place in my prayers - for wisdom and the two new potential clinic sites.  They are doing amazing work.  

Click to learn more about New Frontiers

My time in the Masai mara was unlike anything I have ever experienced.  I didn't want to leave. 

We drove 3 hours to the Amani Mara Lodge for our first safari experience.  We were greeted with fresh moist towels and mango juice. We had our own hut.  It was the lap of luxury.  

 The main area was so open and spacious overlooking a river with hippos. It was culture shock.  I took a shower for the first time in 5 days and sprawled out on an excessively large bed. It was almost too much to take in it made my cry. On our back porch, I could see zebras and I felt the cool breeze coming in from the door.  It hurt to leave New Frontiers. It hurt to be at the Lodge. It hurt to hear people complain about ants in the butter, like they literally forgot where we just came from. 

When we finally had some time to sit and relax, I realized how much I love the warmth of Africa.  Wilson, our driver and friend, told us that when dust flies in your face and you cough, that's just Africa welcoming you.  I don't think I've ever felt more at peace anywhere else.  I experienced my first African rainstorm at the Lodge.  Like, it was a real rainstorm. It got very dark. The dust turned to mud. I loved sitting on the porch watching it rumble in with the zebras and impalas in the distance.  Every new place we went to, it rained.  This is an exceedingly good thing. It means we are bringing good fortune and prosperity with us, or something like that.  So basically, we're good luck.

There were two of the most terrifying spiders in our room. Kenya never disappoints.  Our Masai guard came running to see if we were ok, because naturally we screamed. After we closed the door and assured him we were fine (just bravely killing spiders), we heard him laugh at us.  It's not like he's protecting us from lions with a spear and we screamed because of a spider.  

The next day I went on my very first safari.  Apparently it's very expensive to go on safari.  It's a bunch of driving around and looking for animals.  We saw 14 lions, 14 elephants, 10 giraffes and countless warthogs, wildebeest, impalas and gazelles.  And 1 cheetah. I loved spending the whole day out in nature just looking at God's creation. 

 

I know everyone wanted to see the animals, I did too, but it's the landscapes that really got me.  The things that never really show up on camera.  The feeling you get when you see a wide expanse and sense the infinity of it all.  

 As much as I loved safari, I was ready to get back to work.  I'm horrible at doing nothing. It was nice to relax, but i was ready to work again.  



The last evening at the lodge we didn't have any water.  Of course everyone hated this, but I liked it.  A little taste of New Frontiers when I was really missing it.  We opened the doors and windows to let light in since there wasn't electricity either.  While sitting by the door, some zebras grazed by, and they were so close! 

At this point in my journey for some reason I was thinking a lot about love.  Perhaps because Kenyan women are expected to get married, have kids and not get caught in a river with a cow, because they won't be rescued.  But seriously, I thought a lot about love, romantic love, friendship, agape.  These people have such harder lives than I do, but they're so much happier.  I was baffled by the amount of love I experienced in a weeks time and how welcoming everyone had been.  The joy I'd seen in children astounded me.  It made me wonder if that kind of love can satisfy a life.  Do I need to, or am I supposed to share my life with one other person? Or is my purpose to fill my life with love for others and share it with those all around me?  

On to Nyeri.  We were in the car for 9 hours.  We drove from the Masai mara to Nyeri.  Supposedly it was a beautiful drive, but I slept most of the way.  It was surreal to drive on paved roads again.  The smooth road is truly a blessing. And we saw the Great Rift Valley!

They welcomed us with open arms at the Sugarbaker clinic.  We settled in and we had running water and flushing toilets! It is incredibly peaceful in Nyeri.  You go outside and the only sound you hear is birds chirping. We had tea, introduced ourselves, adventured around the clinic and then had dinner.  Gladys is one of the best cooks I've ever met.  She's the mom that asserts you're too thin and you need to keep eating and she keeps feeding you.  

Our first full day in Nyeri was a long but fulfilling day.  I went to the Nyeri Provincial General Hospital.  It was a great learning experience. Doctors are called medical officers and the operating room is called the theater.  Everything is on Kenyan time, which means late or whenever.  I started out in the pediatric ward with the doctors rounds.  A very nice chief medical officer came and talked to us about a baby being incubated, a child with rickets and a boy who needed his adenoids removed.  

I also worked in an outpatient pediatric clinic with nursing students - Kavita, Elizabeth and Isaac.  We weighed kids and gave medications. I'm so glad the students were there. They were so funny, nice and made it a fun time.

  
I also went into a Nyeri grocery store.  People sit on top of ladders in each aisle to watch for shop lifters.  It's one way to do it.  

That evening we went to Huruma Children's Home.  It's for orphans or children whose parents can't provide for them.  Nancy welcomed us, picked us up and called us her daughters.  Of course we had to have tea, bread and cookies.  Nancy kept saying that this is our home and we should relax here.  I really like her and I think I should be more hospitable.  

The children sang for us, which further supports my theory that all children in Kenya sing.  They sang "This is the day the Lord has made, let us rejoice and be glad in it."  It took on a whole new meaning for me.  

Afterwards we went outside and played games.  I played volleyball with the older boys and they kept saying something about Mzungu's (that means white person) so we knew they were talking about us.  Nicholas (a medical officer at Sugarbaker) told us they were impressed that we could play so well.  And that's saying something because they were amazing at volleyball. We also played duck, duck, goose and red light green light with the younger ones.  It felt good and right to be there, like coming home.  

The next day I started out at the clinic.  It was pretty slow at first, but we had wifi for a little bit which was very exciting.  Later in the day we did home visits.  We saw 3 patients.  A baby and 2 men with diabetes.  

They have been following the baby because 6 weeks after he was born, the mother was raped, father killed and the perpetrators tried to suffocate the baby with a pillow.  But Charles is wonderful and is a very handsome baby.  I got to hold him for a little bit.

The first diabetic we visited was very welcoming and his wife brought out chairs for us.  He has a piece of rope he uses to pull himself up.  He's been walking more, but not adhering to his glucose checks.  His A1C was over 8 when it should be below 6. 
  
The next diabetic was taking the wrong medication.  Apparently pharmacists, or "chemists" as they're called, will just sell whatever they have even if it's not what the doctor prescribed.  This man was prescribed for 850 mg Metformin and he was getting a generic 500 mg for double the price he should be paying.  It made me sad and angry that he was being taken advantage of.  I hope he comes to Sugarbaker clinic to get his medications from now on, since they charge half of that price.  

Susan really wanted us to stay for tea, but we simply did not have enough time.  Big cultural no-no on our part.  You always say yes to tea.  But it just couldn't work out.  So she ran inside and brought us out a bag of muffins.  That is like the epitome of my trip.  People who struggle to feed their family but always offer tea and food to a stranger/guest.  

Later on we went to the local primary and secondary schools.  The headmaster at the primary school, Samuel, made my heart so happy.  I could see the genuine love he has for this students.  It makes me hopeful that people like Samuel are in Kenya and dedicated to the next generation.  I hope I find something I love someday as much as he loves his students.  

The secondary school was also interesting to see.  We saw several classrooms, labs and the surrounding area. I have also concluded that all teenage boys are the same cross culturally - so much angst and coolness.  

Later in the afternoon we went to Tumaini Children's Home.  It is so nice! They have a sewing program, computer program and we bought soap from Grace (she grew up at Tumaini) for her business.  The kids were so much fun.  We played the game we learned in Masai land where you clap slow, then faster and then you chase them.  They love it, every time.  Then we switched it around and they chased us.  It was unbelievable how much fun they were having.  I'm also really out of shape.  Before that we had tea and I was just hitting a wall.  But after playing with the kids, it was like a surge of life energy.  It didn't matter how tired I felt or out of breath I clearly was, I ran with Kenyan children.  We ran hard and fast together, laughing, and man were they fast.

I pray they continue to run hard and fast toward their goals, dreams and the Lord.  Run hard and run fast, don't stop.

I also met Jane, who asked me when I was coming back.  I hope soon, Jane.

Next it was free clinic day. Let the free healthcare, begin! 
We saw over 100 patients, which is great.  I worked in the pharmacy all day.  I think I was pretty good at it and deserve an honorary pharmacy degree.  

On this day I learned that med math does matter in real life.  I reconstituted meds, converted dosages and counted out the right number of pills.  It was a lot, even though it doesn't sound like it.  

We had a farewell dinner that night.  The food was immaculate, overwhelming and just so much and so good.  Gladys really outdid herself.  They gave us gifts and we gave them gifts.  And of course everyone had a 10 minute speech.  Honestly these were some of the kindest and most generous people I have ever met.  They compared us to the Good Samaritan for crying out loud.  They loved us so much and so well, it has challenged me to love others that much in my own life.  Nyeri definitely has a piece of my heart and  is a place I can now call home.  

On our way to Sweetwaters we stopped at the Equator. Pretty awesome.   

Next stop on the list was Sweetwaters for our second safari.  It's another world there.  It's a Serena trademark, which is the best you can get in Kenya.  It is so incredibly luxurious.  I felt like I was in one of those fancy tents from Tarzan, complete with lanterns.  I could hear so many animals, bugs and strange birds.  I didn't realized how much I missed salads. Immediately after lunch all I could think about was dinner, it was that good.  

We went on an afternoon safari and I finally saw a black rhino! That makes 4 out of the Big Five: rhino, lion, buffalo, elephant and leopard (sneaky, sneaky nocturnal leopard).

We stopped at a Chimpanzee sanctuary where we got mud thrown at us.  It was cute though.  And every time the chimpanzee (Poko) threw mud, he clapped his hands. Oh Poko. And we fed/pet a blind black rhino named Baraka! 

In my journal I literally wrote "I'm still thinking about dinner, it's in 15 minutes. This bed is so comfortable it's making me tired, and hungry. Dinner is so soon! I can't tell if there's birds or monkeys outside. I wonder what monkeys eat. Speaking of eating, dinner..." I'm not proud of those moments, but it really was delicious.  

The last night I did an extra night safari with another girl on the team.  Within 2 minutes of driving a white rhino crossed our path, narrowly missing our vehicle.  We also saw 2 aardvarks.  Aardvarks are quite tricky to spot and are strictly nocturnal. Legends say that if you see an aardvark, you'll live to be 100.  So I'm living to 200, right? 

After our time at Sweetwaters, we drove back to Tumaini for church service.  The children sang, the message was about holiness and we got to hang out with the kids afterwards. Ann came and basically grabbed me. She showed me around everywhere.  She showed me her room, pictures and I met her sister.  She told me about her dad who died and talked about how it's okay to be sad sometimes.  I got my hair braided by several Kenyan girls.  

We danced and sang and it was a great time with lots of life. They asked me what my talent was.  Does eating count? Gladys cooked us lunch and I was pretty talented at eating it.  

Next stop, we arrived at Kenyatta University in Nairobi.  It was strange to be in dorms again.  They were very nice dorms and the biggest shower I've seen for a dorm. There were mosquitos everywhere, naturally. And there were holes in my mosquito net. Such is life. We watched Kenyan music videos on tv, which weren't quite the same as the spanglish soap operas we experienced in Nyeri. But it was still tv and for that we were grateful.  

The next day I wrote in my journal - "Today, I had noodles for breakfast. I miss Sweetwaters. No but today was a good day, just long."  I'm telling you, once you experience Sweetwaters it is very difficult to come back from that. 

We had lectures from some of the nursing faculty, which was very interesting and I took a lot of notes.  It was interesting that we had these lectures at the end of our experience after we had seen and heard so much. They presented the information in a very idealistic manner, and I can't blame them for putting Kenya in the best light possible.  We do the same thing in our country.  But I could tell they wanted to present a positive image of Kenya and not everything they said happened in real life. For example, it is a law to submit part of the workers paycheck to the national health care policy.  But from talking with the mothers at Heshima, I knew this did not always take place.  It reminded me of school.  Just because they teach it doesn't make it real.  

We interviewed some Kenyatta nursing students, all were male surprisingly.  

There are more male nurses in Kenya than in the US. In the US about 10% are male, while in Kenya it's closer to half. We talked about the difference in US and Kenyan nursing programs, job opportunities and our goals in life. One student said women aren't as bright as men and that's a fact and that it's probably the same in the US.  Personally, I'd like to know where he's getting his "facts." It made me pretty angry when I heard about it.  And it made me sad because that's so widely accepted in Kenya. I want more for the women in Kenya. But I still feel like I learned a great deal from these nursing students, despite their opinion of women.   

Our last full day in Kenya we worked at Kijabe Hospital, which is a private mission hospital.  It made my heart hurt because that is supposed to be one of the much better hospitals compared to the government ones. Mary, a nursing student there, showed me around all day. I saw a child with hydrocephalus, a lot of club foot patients, jaundice and GI issues.

 We also worked at Cure, which is a hospital that provides medical care and surgeries for kids with physical disabilities, like club foot. It amazed me how many white people were there.  It was strange.  Being a minority is a strange and wonderful experience.  
Click to learn more about Cure

Our last day we went to Spinner's Web to get last minute souvenirs.  We dropped Kate off at her guest house, which was very sad. But I know she is still doing great work there. We dropped Prof. Floyd back at Kenyatta, equally as sad.  We did a lot of parting. 

And we went our separate ways in the Heathrow Airport. And I don't think I've ever said this before, but I was so excited to use the airplane bathroom. That's saying a lot when the airplane bathroom is 10x better than bathrooms we've been using for 3 weeks. 

It's impossible to know where the future may lead, but my experience in Kenya has transformed how I will practice nursing. Working and learning in Kenya these past three weeks has been a life changing experience.  It has also been a time of life affirmation.  For a few years now I have felt called to do medical missions in other countries.  I have also felt personally challenged to further my education past a Bachelor's degree to be able to make more decisions about a patients care and enact last changing on a larger scale. At this point, I am prayerfully considering pursuing being a Nurse Practitioner and a doctorate degree. Kenya has left a lasting impression on me and will transform how I practice nursing both domestically and abroad. 

Visiting Kenya and working in the hospitals, clinics and primary schools was my first time practicing nursing in an undeveloped country.  Three patients to a bed, reusing isolation gear, and scantly washing your hands, surrounded me.  Not to say that I should put patients in beds together, not throw away isolation gear or wash my hands less.  But it got me thinking about how much stuff we use in the healthcare field and how much that stuff costs.  The next time I put on isolation gear and walk into a patient’s room, I will stop and be thankful that I can throw it away afterwards.    It also made me wonder about all the tests we run and how much those tests cost.  Out in the bush, there was no equipment, x ray machines or labs to run tests.  We had to use reason, knowledge and critical thinking to deduce the best course of care of the children in the primary schools.  This has challenged me to use more critical thinking and reasoning in my own nursing practice.  Instead of running to do a test or poke someone with a needle, perhaps I can stop and think first about what makes sense.  Also not to say we should not run lab tests or blood work to diagnose patients, but I think it is important to continue to critically think and reason about what is going on with our patients.  I wonder how different my schooling would be if I knew I would not have access to fancy tests and procedures.  I imagine I would learn much more about diseases, how to recognize them and how to treat them in a deeper manner.  

Also while out in the bush, I learned how it important it is to use what you have.  While doing a wound dressing, we did not keep the gauze sterile and I used water from my bottle instead of normal saline.  We knew it was not feasible to keep it sterile surrounded by so much dust and dirt, and we simply had no sterile saline.  But it worked, we were able to dress the wound, and it was better than if we had done nothing.  I must keep in mind in my own nursing practice to use what I can, know what resources I have for my patients and what will work for them.

While in Kenya, we were not able to readily access the Internet.  There were several times I wished I could simply Google something I did not know.  While I do have this luxury in the United States, my experience in Kenya challenged me to know more than I do without having to look it up.  Especially since I want to practice nursing in other countries one day, who knows whether that place will have Internet.  Even though the standards for nursing in Kenya and the United States are very different, I feel that I have learned a great deal from practicing nursing in Kenya.  I have learned to think critically first, use what you have, try my best to know as much as I can without looking it up and to be thankful for what I do have. 

I want to be able to enact change on a larger scale and be able to make decisions in a patient's plan of care.  It's hard to hear difficult things and feel like you are powerless to do anything about it. It's difficult to hear about how disabled children are "cursed," female genital mutilation is still widely practiced, a woman must secretly get HIV treatment, and there are 3 patients to a bed at times in hospitals.  Despite all of this, I see hope for Kenya.  I see hope in places like Heshima, New Frontiers, Tumaini, Huruma and Sugarbaker.  I see courageous people doing great things for Kenya.  And it has challenged me to examine my own life and career choices to better myself and help however I can.               

I'm learning more and more that education is paramount. And it is something I take for granted almost every single day.  A question was posed to me and I thought it was a great question - If you returned to Kenya next year and had $5,000 in grant money, what would you choose to do with that money to improve health in Kenya?

If I returned to Kenya next year and had $5,000 in grant money, I would choose to put this money towards education to improve health in Kenya.  I would educate about HIV/AIDS and the transmission process.  I would educate young girls about empowerment. I would educate about circumcision and how it is related to HIV. 

$5,000 does not sound like very much, but in Kenya it would take me a long way.  I could spend time with the people in the community and hear what they need from their own point of view.  It’s difficult to know where to start to help improve health in Kenya, because their issues run so deep.  I would be tempted to provide hundreds of free clinics and medicine.  So, so tempted. I would want every child that is sick to be able to get treatment.  

But, I do not think that “stuff” (and yes, that includes free medicine) is going to help in the long run, even though it might help in the short run.  

I think the only way to enact lasting change in Kenya is to educate the rising generation.  And it’s difficult as a white, educated, Western person to come in and say what needs to be done.  Do I really know what needs to be done to help these communities?  Before I went to Kenya and even during my trip I would have answered yes.  But now I am not so sure.  

I would spend this imaginary grant money to live life with these communities and truly get to know them on an intimate level.  I would want to gain their trust and friendship and learn about who they are as a community.  I have learned that culture runs deep in Kenya and you cannot change a culture or mindset overnight.  I cannot simply go in and say, “women are important and should have rights too” because it would not be taken seriously.  I must truly immerse myself in the culture, language and people before even trying to help them.  And I think that’s extremely difficult to admit, especially for a Westerner who loves fast and easy results just as much as the next Westerner.  But that is not the case with Kenya, and I would argue with Africa in general.  

We know HIV/AIDS is rampant throughout Africa and I could use the $5,000 to provide free ARV’s for five years for a community.  But what happens after that five years?  Everything will go back to the way it was five years ago.  But if I take that money, invest in education programs about HIV/AIDS in primary schools before children are sexually active and teach them about how to avoid transmission, now that could be something lasting.    

You cannot help someone you do not understand and you cannot tell people what they need.  You must start from the bottom, not the top.  Someone is not poor simply because they live differently than you.  And you cannot just throw new shoes and toothbrushes at them and solve the problem.  The problems in Kenya are deep, cultural and traditional.  It is important to come, see and serve.  And now that I came, saw and served, I am responsible for what I learned. I am responsible for my life choices, career choices and how I live my life. I must give myself, not stuff. 

I feel like one of my favorite authors, Shauna Niequest, explains it so well.  

"Africa is nothing if not evocative.  It's a place of such unimaginable beauty and dignity and expanse and possibility, and such unfathomable suffering and despair and disease and decay.  It is at once so alive and so wracked by death, so powerful in its landscape and physicality, and so powerless under the weight of famine and political upheaval and disease....


Everyone I know, it seems, wants to go to Africa, wants to volunteer for a few days in an AIDS clinic or an orphanage. And that's good.  It's a good impulse to want to see it with your own eyes and to want to be part of the solution. I encourage them to go...but inside myself, I whisper to them, be careful.  You will be haunted by what you've seen and heard.  You will see things and hear things, and then you will be responsible for them, for telling the truth about who you are and who you discover you are not, and for finding a way to make it right... 

I had to make something right there, which is both enormously daunting and shockingly simple.  Daunting because of how massive and tangled the roots of the issues have become – it is about famine and sexual violence and patriarchy and racism and economics and medicine, and when you think you’ve knitted together the magical solution, one pull on one string unravels the whole thing and leaves you with a mountain of new questions, while the clock ticks away lives by the dozen.  

And then again, shockingly simple, because there are such good, smart people doing such courageous, good, smart things, and what can be done with tiny little bits of money is just dazzling.” 

Asante sana Kenya, nakupenda. 
(Thank you so much Kenya, I love you)