30.11.09

What Would You Pack - Part 2

The Faders are packed and ready to fly to Kenya.

I have concluded that packing for a move to Africa can be particularly challenging for someone of Dutch heritage. I, Heather, am 100 percent Dutch, which means that I have been genetically and culturally preprogrammed for extreme thriftiness.

This causes trouble in that I tend to resist throwing things away and leaving things behind. We Dutch people don’t throw away anything that could still serve a purpose. My father reuses his plastic sandwich bags until they disintegrate. I still run in a sweatshirt that I acquired when I was in 4th grade. It is now 23 years old and unraveling. I thought I should bring it to Kenya, but Jason put his foot down.

In addition to thriftiness, Dutch folks also have a tendency towards caution and preparedness. My parents never let the gas gauge fall below half full. I always keep a stockpile of household necessities, because we Dutch never run out of anything; we wouldn’t want to have to pay full price if we ever bought anything in a pinch.

It seems that these Dutch traits do not encourage the process of condensing one’s belongings down to twelve suitcases. But we did it. Now I really hope that all twelve pieces of luggage will arrive in Nairobi with us on Tuesday.

In other news, Abi is doing GREAT. Here is a picture of how happy she is about heading to Kenya tomorrow.

22.11.09

Short Stories from Tenwek Eye Unit - Son of the Left Handed One


I hear the word "Mosonik" coming from the little, old lady sitting in front of me.  There were many other words, but this one I knew.  It means, "left handed one."  In general, being the left handed one is bad anywhere outside of the West, and this was clearly directed at me.  She seemed nice enough.  She was probably 80-ish, worn by years of labor in the fields.  She had gargantuan earlobes, stretched as is typical of the older Kipsigis, and a particularly captivating smile.  Why the insult?  I had come from Tenwek 150 kms on bad roads to the bush to help her.  Well, after some investigation, she was only calling me the son of Mosonik.  That makes it all better!  Would you rather be called a donkey, or the son of a donkey.  I can't decide.

This is actually the greatest of compliments.  As it turns out, Dr. Steury, who was the first doctor at Tenwek 50 years ago, became known as Daktari Mosonik.  He was not left handed, but when the Kipsigis saw him operate and use his left hand with such agility, word quickly spread through Kipsigis land, and apparently to this nice lady in the bush.  He was much loved and revered.  It is told that people would walk days to be treated by Mosonik, many of them walking by other rural dispensaries on the way.  Why?  "Because his hands are gentle."  He served the Kipsigis with Christ-like compassion and humility.  I'm sure I'm not the first young mission doctor to be called the son of Mosonik, but I still count it a great honor.

As I examined her with my flashlight in our make-shift office in the x-ray room, it was clear that she was blinded in both eyes by cataracts.  Her only chance to see again was to have surgery.  She and several other surgical patients waited for us to finish up our screening camp at this rural government hospital.  Then, we all hopped in the Tenwek Eye Unit bus for the long ride back to the hospital.



She was admitted that Monday night to the eye ward.  On Tuesday morning, she and the other folks enjoyed some singing and a brief testimony of God's goodness with the eye staff.  Everyone then walked next door to our pre-op testing area.  My lady was the first to be scanned.  We measured the curve of her cornea (the clear windshield) and the length of her eye with an ultrasound.  This allows us to replace her cataract with an artificial lens of the appropriate strength so she can see clearly with no to minimal correction with glasses.  In the picture below, she is sitting next to me on the far right of the picture.


Did I mention this was going to be my first small incision extracap cataract case in Africa?  Everything is different.  The microscope, the instruments, the staff . . . NO PRESSURE.  I'm just the Son of Mosonik to this lady.  Off to the O.R. we go.  Thankfully, God was gracious and allowed everything to go smoothly.

Post-op day one she looked great.  She and her friends got a ride back to the bush with their new eyes.  Below is our  post-op day 10 visit.  She is waiting to get enough money to do her second eye.  I admit, she's may favorite patient to see.  She always brightens my day.



20.11.09

Introducing Alyssa

There are, of course, many new people that we will be getting to know in the next several months, and we will try to introduce some of them as they come along. Alyssa Pfister is a Internal Medicine and Pediatrics doc (and thus will be an oft-utilized reference point for Eric's work) from Nashville, who has been in Alabama for the last several years. We all met her 1 year ago in Louisville, when it became evident that she would also be in the Post-Residency Program, and she would also be at Tenwek hospital. At that time, we offered to rename our group the PmcCropders (with a silent "P", of course, as in "Pfister"), but she said she wasn't ready for that kind of commitment. We also got to spend some more time with her in Bristol this last spring (as pictured above), and now she is partying hard with the Cropseys in Kenya, as the rest of us wait for our departure dates.

So, her own blog, permanently located on the right sidebar, will offer another insight into our environment at Tenwek, and will also sometimes have overlapping experiences with the McCropders. Currently, you can find pictures of her with the Cropseys, hiking down to the nearby waterfall/hydroelectric dam.

PS. After visiting her blog, you may think all Kenya bloggers are required by international law to use the same blogger template. That is not the case.

Africa is Rich

A link to a very interesting site, Aid Watch, and particularly to their recent post, "Africa is Rich", which is an excellent reminder that people and cultures are multidimensional, and Africa is much more than "the poorest place".

16.11.09

What Would You Pack?

The Cropseys have made it through. The Faders are in the throes of it all. And the McLaughlins see it looming on the horizon. What am I talking about? Packing, of course. I thought it would be an interesting exercise for our faithful readers to think about what you would pack if you were leaving the country for two years...and you had around 8-10 suitcases or so (for your whole family). 50 pound limit, of course. I think the Cropseys had 13 bags, and the Faders get 11, while the McLaughlins get 8 (a complicated algorithm based on the number of children you have and the number of plane tickets purchased for your family). We are moving into furnished apartments, so no worry about carting your bedroom set over, but there are definitely kitchen gadgets that need bringing. The Cropseys brought their Kitchenaid mixer. The McLaughlins are bringing a food processor. And things like laptops are a must. We need to bring some bedsheets, obviously clothes, entertainment, and things that would make our house a home for the next two years.

So I ask again, what would you bring? Things on our list currently include Eric's guitar, Maggie's Christmas toys, and a cuckoo clock from my parents' trip to Germany in 1977. Our Pampered Chef knives, and a down mattress pad. Luxuries? Yeah, I guess. But some things are worth bringing. Do we take the Christmas ornaments to start some traditions? Obviously not if it means we leave the 20 BumGenius diapers for Maggie. Settlers of Catan? Of course! Betty Crocker? Absolutely. But I have a sinking feeling that when it comes time to pack our pile of necessities into 8 suitcases, some things just aren't going to make the cut. Maybe that means they aren't really necessities after all.

6.11.09

Trust and Real Estate - Part 3

Part 1 is here.
Part 2 is here.
By God's grace, there will only be 4 parts, and the next one will be one of resolution.

For better or worse, my habit of turning life updates into sermonettes will not avail today, since I can't think of anything new that I've learned from this process. Not to say that I've mastered the old lessons either.

However, since many of you inquire periodically about the state of our home sale, we wanted to give an update. If you are reading this, you likely already know that our departure has been delayed for two months, while we raise some capital to cover any contingency plans for our home sale difficulties, and we are spending that time working at a Navajo facility in Gallup, New Mexico.

After much deliberation and talking over the nuances with a few trusted people, we decided to pursue a short sale of our house. I won't go into the details of this, but basically we find a buyer for less than our mortgage balance, and propose it to the bank, who hopefully then accepts the offer and forgives the rest of the debt. I know we are far from the only people going through real estate difficulties, and if you have questions about the details, you can contact us.

The next step was to find a buyer. Thankfully, we did not have to lower the price too much more before we had an offer. We have now proposed this offer to the bank (with the help of a short sale expert), and we have anywhere from 6 weeks to 6 months before we get a verdict. Thankfully, the proposed buyers are local, and thus are more likely to ride out the long wait. Though this may seem like a headache, we are actually quite excited, that this may signal the end of a very long ordeal.

First, we want to thank those of you who have looked at our difficulties and asked whether or not God wants you to be an agent of help. This is amazingly humbling to us, and we believe it is very near the heart of Christian faith. Thank you.

Second, we hope that this update helps you all to know how to pray for our situation, namely that the buyers stay interested, and that the bank says yes. We're pleased to have crossed this threshold, but the need for trusting God is still very prominent, which I guess is a lesson that is worth continuing to learn.

1.11.09

Short Stories from Tenwek Eye Unit - Part 1

We (the Cropsey gang) had just arrived at Tenwek Hospital.  I (John) wasn't officially starting work until the following week, but I was anxious to see the Eye Unit.  It was a "slow" Friday afternoon around 4 pm, so Ben Roberts (the ophthalmologist I'm joining) said to stop in for a quick tour.  There were exactly three patients left to be seen on my arrival.

The first was a six year old girl.  She had bilateral, pan-uveitic, neuro-retinitis.  Even if you don't know what that means, you know it can't be good, right?  Well, our testing is limited and some Western tests are nearly useless.  So, based on her elevated ESR (a blood marker for inflammation in the body) and history, we thought she most likely had tuberculosis in the eyes.  We sent her to peds for a late Friday afternoon lumbar puncture to rule out further central nervous system involvement and systemic treatment.  The peds department is loving me right out of the gate, I'm sure of it.

The next patient Ben runs by me was also a six year old girl presenting with a V-pattern esotropia (eyes turned out and make a V pattern when she looks up and down).  She had swollen optic nerves suggesting possible increased intracranial pressure.  Also, not good.  Imaging with an MRI scan, or at minimum a CT scan is needed.  We don't have either.  The family will have to take the girl over a 100 miles away to find a scanner.  The cost will be an enormous burden for this rural family.  And if the scan confirms an intracranial mass, it will be extremely difficult for them to find a neurosurgeon, let alone pay for one.

To finish my orientation, I finally get to meet an adult.  She is a pleasant 40 y.o. lady who says, "I was sitting under a tree and a fly hit me in the eye.  About five days later I began to lose vision in my right eye."  She is following up several months over due.  Below are pictures of the back of her eye on initial presentation.



For the non-eye folks out there, the pink structure with the white hole in the middle and all the vessels coming out of it is the tip of the brain entering the back of the eye, the optic nerve.  All of the little white "trails" on the nice orange retina are not normal.  It almost looks like worm tracks, doesn't it?  Do you see the larvae next to the right of the optic nerve?  That's right!  He's the white outline chewing away under the retina.  This disease is called "ophthalmomyiasis."  The treatment: cook the bugger with laser!  The problem: he is munching next to the tip of the brain, the part that does the seeing.  Also, not good.  By the time Ben got her to the laser, this is where he had eaten to:
 

It is clear at the edge of the retina, far away from the optic nerve and central vision!  This is good.  The white patch is from the laser burn which marks the worm's grave.  The woman had done so well after the laser that she did not follow-up as asked.  This was a bummer for Ben because he presented a case series of ophthalmomyiasis x 3 at a retina conference the week before in New York City.

This ends my first hour in the Tenwek Eye Unit.  Needless to say, I have many more stories, many of them deeply moving, from my first month here.  I daily find myself seeing things I've never seen before.  I often ask God for wisdom and compassion in clinic and the O.R.  I try to categorize things: Really BAD, bad, probably not bad, no big deal.  If it's towards the badness end of the spectrum, I might grab a book and look for its ugly cousin in the pictures section, and then figure out if it needs to be cut out, treated or just watched.  You can read and see more in Part 2 to come shortly.  Note: all photos were taken with the patient's permission, and this post is being sent before Jessica proof reads it.  This is always a regrettable choice in my experience, but I'm posting it anyways.