• ashirk@gmail.com
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Year in Review: Big Picture

Year in Review: Big Picture

Where are we going? What are we doing?  They were the questions of the year last year.  12 months later, we have a lot more answers. . .

We arrived in Kijabe September 24th last year. The girls started school at Rift Valley Academy on the 26th, and David and I started Swahili lessons on the 27th.

For the first two months, we did language lessons every day. Lots of flash cards, lots of practice, and lots of unpacking and reassembling in the downtime. At the end of the 2 months, I continued to do lessons 2 days a week, and David continued 5 days a week. David’s way ahead of me now, but I can understand what my residents and nurses say and get a basic history from my patients. In Kenya, the official languages are Swahili and English, but everyone also speaks their tribal language and about a fifth of my patients speak Somali. So, as we say in Swahili – pole pole – slowly, but steadily, we are learning.

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We had gone from 10 years of life to 13 bags, and starting over was both overwhelming and strangely reassuring. We moved into a 3 bedroom duplex with a big yard and a garden, and we spent the other part of the first 3 months getting appliances and furniture, learning how to hang clothes on the line and how yeast is magical when you are making bread and pizza dough from scratch. David learned what vegetables and fruits are good when at the market and where to buy apples and eggs, where to get fresh chicken, and where to get milk from a cow and how to use the pasteurizer. We learned to close the windows in the afternoon so the monkeys don’t steal the food on the counter and whose yards had trees with limes. We got adept at making meals for last minute dinners with friends,  and David had a grill built so we could cook when the gas ran out for our oven (or whenever, really). I got really good at making guacamole and chocolate chip cookies, and we went on a hunt for cheese and ice cream. Things that seem normal now, but at the time were incredibly daunting.

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I started at the hospital at the end of November, right before Thanksgiving. I joined a team of 3 other pediatricians and some longer term short term doctors. In May, the short term doctors left, and in June, another went on maternity leave and yet another returned to the States. Ima, my fantastic department head, and I have been the 2 long term pediatricians since then, and have received help from 5 different wonderful short term pediatricians from the States and Canada since then to fill in the gaps. I take 24 hour call anywhere from 5-7 times a month, and work an average of 6 days a week from 8-5 (or 6).

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Every day, we have about 20-25 babies in our nursery/NICU with at least 5 or 6 in incubators on respiratory support and the rest on IV fluids, oxygen, or antibiotics. We have 18-25 pediatric inpatients on the children’s ward and consult on the various neurosurgical and pediatric surgical patients. As David says, a lot of my patients are similar to the states, except most of their illnesses are also complicated by malnutrition and TB. Of the 19 patients I rounded on this morning, only 4 of them are normal weight for age. We also have a 5 bed ICU which is about 60% pediatric patients, so much of my time on call is spent managing ventilators and IV blood pressure medicines on the sickest babies and kids. We also have busy outpatient clinic that sees 20-30 patients a day and a developmental clinic once a month for some of our most vulnerable patients. In a month, Sarah will be back full time after maternity leave, and Nate, a new pediatrician, will join us and we will finally be back to full staff, which is incredibly exciting – especially since we move into the brand new 70 bed children’s wing starting in January, which will make us even more busy. . .

I also spend at lot of my time teaching and mentoring – medical interns, clinical officer interns, clinical officers, emergency critical care trainees, and nurses. I am never alone here and always teaching, which is one of the biggest reasons we came to Kijabe, but, that is for another post.

David has had his hand in every area of the hospital and Kijabe in the last year, which has been amazing to see. In addition to Swahili and getting the girls up and down to school, coaching 1st graders in soccer, making sure we have food and coffee, wrangling the car and internet and countless repairs on our house (from leaks in the roof to leaky showers to kitchen overhauls) and building our furniture, he has finally been able to be part of my life at the hospital in a way he never could have been at home.

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Taking years of running a small business and his knack for seeing things in a new way, he has revamped the way the hospital presents itself. He maintains the hospital Facebook page – taking pictures, telling stories, and keeping up with day to day changes and updates. He started a hospital blog, keeps the hospital website up-to-date, has written a book of the hospital’s 100-year history complete with photos, designed the quarterly newsletter, and was a major facilitator of the Centennial Celebrations in May.

He was also just named Deputy Director of the Friends of Kijabe Board which will establish our hospital as an official charity in the US for support and donations in the coming months. He has been organizing fundraising and grants for new oncology equipment for the lab and the Elimu Housing complex. This, along with welcoming so many short term visitors and getting to know our chaplains, security guards, and just about everyone else in the hospital. (I am definitely David’s wife to a lot of the hospital employees.) His official title is International Resource Mobilization Officer, but, as you can see, it encompasses so much more. His next project is going to be more like a Humans of New York for Kijabe. . .which I’m really excited about, and also posting here to hold us to it happening :).

The girls are thriving. . .they love Kijabe, and we love the simplicity that being here brings to their lives. They have made wonderful friends, created countless imaginary worlds in the nooks and crannies of Kijabe, and most days can be found covered in dirt and deep in conversation about the day’s newest adventure.

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We saw sunrise over the Indian Ocean, had our campsite invaded by elephants, monkeys stole grapes from our kitchen table, the girls visited Paris, David climbed a volcano and broke a shoulder, the wheel fell off of our car, we read the Wingfeather Saga, we skyped with family, made new friends, watched over 65-patients per call-night, laughed, cried, and loved our new life.

Next year will hold a lot of the same and expand our roles even more as the day-to-day is less daunting. Each day, I feel more of an ability to really see the world around us. As of last week, we are officially transitioning to Serge to extend our time here for 5 more years (and hopefully even more) after I finish my term with the Samaritan’s Purse Post Residency program.

The biggest thing we have learned this year is that although we are on the other side of the world, we have never felt such incredible connection to our friends and family. The outpouring of love, prayers, and constant encouragement is truly our lifeline – we hope to continue to bring that strength and love to Kijabe for years to come.

 

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