Sukuma wiki is a classic Kenyan dish of chopped greens cooked with salty spices. The greens grow year-round in thousands of gardens in Kenya, and they look like this:We had bushels of this stuff growing at Tenwek. The closest vegetable that we can find in Ann Arbor is kale. So we chop up the kale in small strips and then cook it with onions, tomatoes, turmeric, fennel seed, cumin, ginger, coriander, and a few other spices, and it actually tastes really good!
Sukuma wiki translates to "push the week." It goes by this name because eating sukuma wiki (which costs almost nothing in rural Kenya) can push a family though a week on a small food budget.
In Kenyan fashion, we eat sukuma wiki with chapati, beans, and ugali. Jason has mastered the preparation of this meal (which requires no silverware!). He orchestrated the preparation of the dinner below so that we could share Kenyan cuisine with some friends last weekend. Yum!
Here's the updated level of financial support given/pledged (averaged for all McCropder accounts):
- 79% of minimum necessary monthly support
- 55% of needed one-time start-up costs
This is how we feel about the increasing support levels:
It is difficult for me to say for certain, since I am decidedly a medical person, but I think Gawande has a knack for explaining complex medical issues in layman's terms. He seems to write about things in a way that makes a lot of sense and is incredibly interesting. How else could I have stayed so interested in a chapter on hand washing? The book is a great look at how we do what we already do...better. As physicians, we almost always have the best of intentions. We know what has to happen. But how does it actually get accomplished? If, for example, we know that washing hands stops the spread of disease, and it's easy and cheap, 100% of people must wash their hands, right? No, not even close, says Gawande. Why? How do we improve?
He illustrates his point and talks about various aspects of the problem by focusing on a different issue each chapter: polio vaccines in India, APGAR scores, trauma surgery and developments in the military, cystic fibrosis, malpractice suits. It's nonfiction, but Gawande's way of making his point through story left me flipping pages rapidly.
I was hooked after a page or two, but I felt like we were really connecting as I read his final story. Gawande is Indian by birth, and he went back to India during his training to spend a few months working in on of their hospitals. He recounts an incident where he was trying to place a chest tube in a man dying from a massive pleural effusion (fluid around his lung causing it to collapse). The hospital had a CT scan and the ability to do angiograms, but no chest tube. No scalpel. No pulse ox. The man died. As I read this account, it reminded me of all that we are trying to do in the developing world. There are days where someone has donated some new equipment, or we open a new hospital wing, or implement a new program. These are all GOOD THINGS. But when patients are still dying because no one checked their vital signs, or we have run out of IV fluids, BASIC things, then it begs the question...do we need to work on doing what we already do, better, before we move on to something new? Gawande asks the question. Something worth pondering.
|Half of my Gorgas classmates pictured with nurses from the clinic we visited this week|
|Note the top of the picture: Smear positive tuberculosis resistant to almost all of the most used TB drugs - rifampin, isoniazid, pyrizinamide, and streptomycin|
|Our patient's daily six drug regimen|
|Map of the world with proportion of tuberculosis cases per country|
It's estimated that worldwide only 7% of all multi-drug resistant TB cases are diagnosed (due to a lack of laboratory facilities, rapid tests, funding, etc.). But if you're a ministry of health official for a poor country and you can treat 250 susceptible tuberculosis patients for the price of 1 drug resistant patient, where do you put your efforts?
- Wow, it would be great if I had 4-wheel drive. Instead, I have a 2-wheel drive van.
- Where is the road? Well, it must be somewhere between those 2 mailboxes (or trees)
- Wow, the Lord has made a beautiful place here. If I try to look around and enjoy it, I'm sure to die.
- Slowing down may actually be more dangerous in this situation.
- I'm so glad no one really cares if I stay in my own lane.
- Well, there are worse things than getting stuck.
- The best thing about this situation is that there are not many other cars on the road.
- When in doubt, trust the ruts that are already in the road.
- Of course, one never quite knows where those ruts led the last person.
- Oh look, they didn't really lead them very well. Better get out of the rut.
- Lord, thank you, thank you, thank you for bringing me safe and sound from point A to point B.
|Driving back from visiting some friends. John has skillz. We never got stuck.|
I like that title because it has so many interpretations. This post could easily go on to relate a struggle with some besetting sin issue and the sense of helplessness and weakness that drives me to lean more completely on God’s grace. It might describe a day in the life of a child struggling with muscular dystrophy or a middle aged man gradually succumbing to Lou Gehrig’s disease (ALS or amyotrophic lateralizing sclerosis). Or, the disease could be more transient, Guillian-Barre or an epidural injection gone wrong and waiting to wear off with time. But today’s post is about the wind, candles, and camping in your own home.
Last night Los Angeles experienced gale force winds as part of our seasonal Santa Ana weather pattern. One report claimed gusts of up to 90 mph. Those who live in tornado- or hurricane-battered parts of the country can easily guess the outcome of such a windstorm - thousands left without power.
I just so happened to be up when the lights went off at home - a crash outside followed by a pop and a fizzle sound inside and my work preparing a lecture on the emergent management of major thermal injury was all but finished. Using my cell phone as a flashlight, I went to the cupboard where I store the candles and got some small measure of light going. “Ironic,” I thought, “that I should be lighting so many candles after having just constructed a slideshow on burns and house fires.”
The lecture went better than the milk in the fridge and at 5 pm the following day I relit the candles and settled in for a dark and quiet evening. No internet. No TV. Only as much computer and phone as my batteries will allow. I cannot very well read by the puny candlelight that I have, much less write in my journal. So what is an over-busy American emergency medicine resident to do with himself?
I take a deep breath and then a nap. I take a little snack and spend some time in prayer. With candles flickering around the house it looks like a seance but it feels like a camping trip. And really, why not use it as a time for special communion with God? There is something emotional, dare I say, romantic, about candles around the house for mood lighting. Perhaps God, in His infinite wisdom, ordained a tropospheric sneeze to extinguish the lamp of the the LA DWP so I could spend this evening with Him. Maybe He cut the cables connecting me to the nuclear power plant south of San Clemente so that I’d rely more on the connection I have to the omnipotent Sustainer. For that, I am thankful...and for the fact that we still have running water.
“Do you miss Kenya?” We hear this question often. I, Heather, definitely do miss Kenya at times, even while I also love being here in Michigan. Missing Kenya sometimes hits like an overpowering wave when we least expect it. Any of the following might cause a momentary transport back across the ocean.
A word: If anyone mentions words like Jolly, residents, chameleons, rice and beans, safari, Orange, waterfall … words like these conjure up good memories and can mysteriously bring us back to Kenya.
A name: Recently, Anna looked up from a book and said, “Mom, I miss Hannah B.” I miss Hannah, too, and her whole family as well. We sat and missed them together for a few minutes.
A feeling: Recently some friends of ours here have suffered an enormous and painful loss. Grieving with them churns up aching in my heart both for their family and for suffering like theirs that we saw far too frequently at the hospital in Kenya.
A contrast: Once a few months ago, I saw a mother kiss her healthy baby, and somehow it pierced my heart as my mind flew back to Kenya and settled on our foster babies who have no mother to kiss them. The contrasts unsettle my soul sometimes, and it can take a while to find my sense of balance again.
A cultural confusion moment: Last week I was saying "thank you" to the girl who watched Abi in the nursery at church. So I shook her hand. And then I remembered that we don’t really do that in this country, but I couldn't remember the cultural equivalent here.
A pineapple: Yesterday Anna and I saw a fresh whole pineapple in the grocery store. She stopped and stared at it for a moment. I recognized that look in her eyes: that look of being suspended between continents.
So if ever a McCropder does not seem to be tracking with you for no apparent reason… just wait patiently, and they’ll probably find their way back to America in a minute or two.