Tenwek on National TV

NTV Kenya (a national TV station) came to Tenwek two months ago to do a short piece on the hospital. We weren't able to find the original online, so the video (available here on YouTube) is simply our camera recording what's on the TV. You'll want to turn the volume way up because it's a little hard to hear, especially with comments from the peanut gallery! John is briefly featured in the video. Unfortunately, he is misquoted as saying that the eye unit did 14,000 surgeries last year! Actually, they did just over 2,000 surgeries and saw over 14,000 patients in clinic. The clip is very well done and a wonderful testimony to all the hard work that has gone into Tenwek for over 50 years. It's a honor to play a small part. To God be the glory!

Now and Then

Last September, I wrote this blog post about the tension between the promises and what I see all around me. An anonymous commenter (that it seems was actually Carlan) mentioned that it sounded like a song to be written, so I tucked it away, and eventually it materialized.

Now and Then

(download)

You and I, we never could say what we really meant

that the promises we hold are positing an argument

They loom so large, and so lovely

Like a dream so far above these dusty trails

and all the places that they ever went

Look around, and see the world that we are living in

Feel the weight of all our fears and all our wanderings

They're pressing in, and leaning near

But just now, not far from here, the darkness hits a glitch

And seems to be wearing thin

Now and then in this weary world

And even here and there inside my ragged soul

A bit of redemption's breaking through

So maybe everywhere

like some whisper floating on the air, it says

"All things are being made new"

Come awake, let us stand and take the darkness on

Wrestling with the angel until the dawn

We may limp, but then we rise, even be caught by surprise

A rent appears, streaking though is a morning sun

What are these kids saying?

Not surprisingly, our kids absorb bits and pieces of both American culture and Kenyan culture. Sometimes the bits of one culture get mixed up with the pieces of the other culture, which explains why they say things like these:

1. Elise: “Listen, when I shout, I can hear my gecko.”
(geckos here are silent lizards, so she must have meant “echo”)

2. In answer to “What’s your favorite food?”

Anna: “Pizza and beans and ugali.”
Elise: “Lettuce.”
(Really?)

3. Micah and Abi and Maggie: All three of the 2-year-olds are making great strides in verbal communication skills. Their growing vocabularies include words like “chai, habari, and chapati.” Sometimes they still seem to be babbling, but maybe I just don’t understand their Kipsigis words. A Kipsigis househelper told me recently that Abi understands and says “Kay-roh,” which means “Look,” and Micah says “Nyon,” which means “Come.”

4. (Upon seeing this insect, which is called a “Nairobi Eye”):

Anna: “Look! It’s a Nairobi i-pod.”

Maybe next year in the US, someone can teach Anna the difference between a Nairobi Eye and an iPod.

COTW - Boss has a Loose Screw or Two

Most people probably think their bosses have a few loose screws from time to time.  And who can blame them?  The pressure of being the Big Cheese, or as we say in Kenya, Samaki Mkubwa (the Big Fish) can be enough to make you crack.  With the added stresses of Africa and supervising the McCropders, our Samaki, Jim Vanderhoof, finally succumbed.

It was a rainy evening at Tenwek when the phone rang.  I answered, and it was the lovely Mrs. Vanderhoof.  She and Jim happened to be visiting Tenwek for some important meetings (Jim's the country director for WGM).  Mrs. V stated that Samaki had been reading in bed when his glasses fell apart.  They observed that a screw had come loose, but was nowhere to be found.

Life's just not fair.  The boss just needed a little break from the madness while enjoying a leisurely read, and his glasses fell apart.

It was sometime later when he felt some mild eye irritation.  Upon inspection, they noted a foreign body in his eye.  Mrs. V exclaimed over the phone, "I think his missing screw landed in his eye, but he didn't realize it until now!?!"  I told her this was impressive and well worth a look.  Jess and I quickly prepared the camera in anticipation of this very blog.

Yes, I'm enjoying every minute of it!

Indeed, Jim's loose screw is identified!

        

After a little numbing drop, Jim's screw was retrieved.  He has since made a full recovery.  But still, one has to wonder how Samaki could not feel a screw hit his eye.  He must have grown some thick scales in his line of work to be able to blunt that kind of pain from his consciousness.  

Book of the Month: When Helping Hurts

When Helping Hurts, by Steve Corbett and Brian Fikkert, has influenced several discussions among the McCropders recently. Corbett is a community development expert and Fikkert is an economist. They present a unique perspective on poverty, which in turn calls for a different way to go about poverty alleviation. The title refers to the unfortunate but frequent situation in which well-meaning people try to help, but their efforts actually do more harm than good for the people they are trying to help in the long run.

The authors begin by defining poverty. They suggest that at creation, humankind enjoyed a perfect relationship with God, with others, with ourselves, and with creation. When sin entered the picture, it corrupted each of those four relationships, and these corrupted relationships embody/define poverty. This is a different view of poverty from the more traditional understanding of poverty, which primarily implies a lack of material goods. In fact, this new explanation of poverty shows that the materially poor often have a lot to offer to the materially rich, in that relationships among materially impoverished people can often be stronger than relationships among those who are materially self-sufficient.

Poverty alleviation, then, is about restoring and reconciling these relationships between a person and God, others, themselves, and creation. Corbett and Fikkert gave some good recommendations on how to alleviate poverty effectively.

• We should focus on people and process rather than projects and products; the participation of all groups is critical to creating ownership and therefore sustainability.
• Systems need fixing too.
• Relief, Rehabilitation, and Development are three different stages of poverty alleviation, and they need different tactics. Using relief tactics (ie handouts) in a development situation (where people can largely help themselves through partnerships) is quite detrimental on many levels.
• Poverty alleviation efforts should start with assessing the resources that people have which can be used to help themselves, rather than assessing what they need.
• There is a good chapter on how many short term mission trips need significant revamping if they are to be part long-term poverty alleviation.

Overall, When Helping Hurts is a very thought-provoking book, and it will be helpful and challenging as we look towards alleviating poverty in Burundi, and indeed, as we aim to alleviate poverty in our own lives through restoring relationships.

Haunted

Yesterday, around noon, we admitted a man in his 50's with known severe heart disease. Apparently, he had been somewhat stable until a couple weeks ago, when he stopped with 4 heart medications. Why? Probably financial, given that even inexpensive medications require time and money to travel to the pharmacy to get refills. Also, many people only marginally believe in "western" medicine, and gravitate often to their traditional healers. And given our lack of ability to help in some situations, it can be easy to sympathize with their skepticism.

At any rate, here he was, sucking air even with our most aggressive form of giving him oxygen. His blood pressure was low and his heart rate was fast in an irregular rhythm called atrial fibrillation. We don't have much to do in this situation, except to restart his prior meds at a bit more aggressive level, paying special attention to try and not lower his blood pressure further. I sent him to our little ICU because (for once) they had room available, even though it had been decided that he wouldn't be intubated if his breathing should ultimately fail.

He died at 3am last night. Even though I was on call, I didn't find out until this morning, which was a bit surprising, but overall fine, since I wouldn't have done anything differently.

He was one of a hundred cases that haunt me. The memory of it will play around the edges of my mind, while I go about my work, laughing with the interns, building a block tower with Maggie, watching the birds, deciding on a course of action for the next patient. Just a bit of a whisper:

Could I have done more? Maybe if I had stayed at his bedside all night instead of in my own bed, I could have bought him some more time. Wouldn't that have been worth it? I should be working harder. Tenwek is all these people have for options. Maybe it would have helped. Maybe if I worked harder...

I think about it when a workday seems kind of light, and I get home at a good hour. I think about it when I discuss a new patient over the phone with an intern and decide that I don't need to walk up to the hospital to see the patient for myself. When one of my colleagues works harder and longer than I do.

Some of this is some kind of warped fear that I need to earn God's approval by trying harder. Some of it is knowing that I have been given much, and much is expected of me. 350 years ago, speaking of medicine, Thomas Sydenham wrote: "He must one day render to the supreme Judge an account of the lives of those sick men who have been entrusted to his care." I wonder what this means.

In the end, there is always more work to do, and we have to make decisions about our own limits. And truth be told, I'm pretty comfortable with where those limits have fallen for me. I'm pretty comfortable, but not one hundred percent. Our lives of full of a lot of great joy, and we thank our all-gifting God for it. Nevertheless, a small whisper continues to haunt. Maybe this discomfort is necessary to keep us diligent. I'll seek some conclusion, but it may just be one of the burdens intrinsic to what we do here.

More Cases

Lots of great cases at Alyssa's blog.

School's Out!

Friday was the last official day of school for the Tenwek missionary kids.  To celebrate, we had a field day complete with games and a picnic lunch.  Heather even got in on the kickball game...in a skirt and flip-flops!

It was sad to finish my last day of teaching 7th grade math at Tenwek.  During the year, we discussed everything from operations with fractions to graphing nonlinear equations.  We had a good year, the kids worked hard, & I thoroughly enjoyed teaching.  Unfortunately for three of my students, they will go back to class immediately after returning from camp next week.  We will start their 8th grade math class in order to get a little instruction in before we (the Cropseys) leave in August.  The other two students get a complete summer break and will be at Rift Valley Academy near Nairobi in September.

From left to right:  David, Kayla, Joel, me (Jess), Abby, & Peter

Heather & I are both thankful for the opportunity that we had to teach these young kids. (Heather taught science to the same class of students.)  These kids are terrific and we will miss them! Congratulations to the Tenwek missionary kids on a successful 2010-2011 school year!

COTW: The Miraculous Protective Advantages of Severe Hypothermia

"Daktari, could you evaluate this patient in Casualty (i.e. ER)?"

Sure. What happened?

"He was found at the bottom of a well. He had gone missing Wednesday night. He's somewhat mentally handicapped, and had just wandered off. They went looking for him, and found him at the bottom of the well this morning."

He went missing Wednesday night?

"Yes."

But it's Monday morning.

I went over to the stretcher. We hadn't been able to get a pulse or a blood pressure, or a oxygen saturation on his extremely cold and wrinkled body. I tried to listen to his heart, but could barely hear it beating over his loud respiratory secretions. He was on oxygen by a face mask and unresponsive. By all accounts, it looked as if he had arrived just in time to die. We piled the blankets on, and then ordered some labs, afraid that, after 5 days at the bottom of a well, his kidneys had shut down and severely messed up his electrolytes.

He spent the night in the ICU, and in the morning his labs were back (things can take a while around here).

Normal. Everything was normal, and he was awake. The nurse who had been talking with him overnight said that she hadn't noticed any kind of mental handicap and concluded that it must be pretty mild. He was discharged home the next day.

I haven't ever seen a clearer demonstration of cryopreservation. I'm quite confident that his risk of dying would have been great, had it not been that his body had gotten so cold that his physiology had just frozen in time. Another wonder of the human body.

Baby Abraham at Our House

Baby "Abraham" is a tiny orphan who lives at an orphanage in another town. This week he spent a few days at Tenwek hospital on oxygen for bronchiolitis. Thankfully, he has recovered well, and now he is a healthy-looking 7-pound sweetheart. I know that because he’s currently sleeping at our house. We are just keeping him until tomorrow, when someone can come to pick him up and take him back to the orphanage. We will be sad to see him go back.
Interestingly, for the last few months, Anna has been asking and praying for a baby. A baby boy. In our house. Several friends and relatives have adopted or birthed new babies recently, and Anna thought it should be our turn, too. I explained that we really want to adopt again someday but that we can’t right now (the process in Kenya requires several years, so we were not here long enough to adopt from Kenya). She still desperately wanted a baby boy here and now.

Her discontentment offered a good opportunity to discuss a few important lessons. So we talked about being content in all circumstances. We talked about believing that God’s plan is best, even when we don’t understand his timing. We talked about why we believe God wants us to adopt babies, and how it will be worth the wait.

Evidently the other lesson, one that I overlooked, was about praying with the faith a child. Anna asked God to bring a baby boy to our house, and she (unlike her mother) fully believed that He could and would do it. And He did.

You could pray for baby Abraham. Thank God for healing his lungs, and pray for his health and protection. And please pray for a family to adopt him. Let’s pray with the faith of six-year-olds.



“But when he asks, he must believe and not doubt, for he who doubts is like a wave of the sea, blown and tossed by the wind.” James 1:6

Kenya in Our Front Yard

It may be hard for our readers to believe it, but there are days when it would be easy to forget we are in another country. Part of that is just that we get used to the strange and different and newness all around us. Part of it is that we live surrounded by other American missionaries, in American style homes, and eat American style food, and have some American style conveniences. For better or for worse, that's what it is. But at some surprising and strange moments during the day, it will hit us all over again that yes, we DO live in Africa. Some days have lots of those moments, getting stared at or running up to the dukas (shops) for a few items, or even cows wandering through our yard on Christmas day.

The fallen branches

I had one of those moments yesterday. We have several large and beautiful jacaranda trees in our front yard here. Unfortunately, they have been infected by some kind of parasitic tree fungus. The hospital gardeners lopped off great portions of the trees covered in this (leafy) fungus, and left the huge piles of branches lying on the ground at the end of the day. This was a very cool moment in the lives of our children, who immediately started playing in the branches (no worries to those of you concerned, the fungus is like mistletoe and is not gross or contagious or harmful to humans in any way).

Anna and Elise's "fort"

Maggie enjoying the fort

I figured that the work crew would be by again the next day to haul off the branches. But the next morning, a group of village women showed up with their pangas (machetes) and started chopping up the branches. They made short work of the trees, and soon had large bundles of firewood which they hauled off on their backs. I'm sure things like this happen all the time in the village, but it was fascinating to watch their efficiency, resourcefulness, and strength from my balcony porch. Next post, the butchery located in our BACK yard.... just kidding (about posting it, the butchery is really there and we can hear the last moos from the mouths of cows twice a week).

Hacking away at the tree branches with their pangas...note the large pile of cut wood on the right

And, time to load up and walk off. I am pretty sure I could not handle this load

Kindergarten Science, East Africa Style

Anna’s kindergarten science studies this year have been a conglomeration of African unconventional home-school topics. Here are a few highlights:

Turtle Anatomy and Physiology: The neighbor’s pet tortoise passed away unexpectedly, so Jason and Anna performed an autopsy. I counted this as science class for the entire week.

Entomology: Our living room in Kenya is an excellent place to collect and study bugs.

Mice: We have had way too many opportunities to study captured mice in our kitchen.

Giraffe babies: A few months ago at Crescent Island, we saw a very newborn baby giraffe.

Giraffe Feeding Techniques: This is how Anna learned that giraffe tongues are both scratchy and slimy.

Sea Creatures: Two trips to the Indian Ocean gave Anna opportunity to study crabs, moray eels, and starfish (who knew that starfish can be red?).

Fishing Attempts: Inspired by the coast, she tried to catch fish back here at Tenwek, but all fishing efforts have been unsuccessful.

Veterinary Surgery: Anna eagerly assisted Jason when a neighbor’s puppy needed stitches.

Hospital visits: On special occasions, Aunt Alyssa takes Anna to the baby nursery at the hospital. Anna loves to watch all things medical. She even watched me give blood last week.

Given the emphasis on anatomy and pathology in her kindergarten science experience, it is not surprising that Anna is aspiring toward a career in medicine. Lately she says she would like to be an ophthalmologist. She is already documenting and diagnosing eye disorders, such as these, including the rare eye tumor on the patient third from the left.

While the above science curriculum might not be approved by standard elementary schools, the good news is that Anna has learned to read this year. Yesterday she read me a story about a dragon and a knight, and she did not even hesitate over words including “knowledge,” “fascinating,” and “disappeared.” After the story, she informed me that dragons actually lived a long, long, long time ago in the 1950s. Maybe next year in home schooling, we will focus more on history.