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.

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.

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".

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.

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.

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.

McCropder-plex Revealed!

Jess Cropsey just spent some time taking pictures of our new digs and passed them along! All three families will be living in the same building. There are five units: 2 upstairs and 3 downstairs. The Cropseys are on the top right, the Faders on the bottom right, and McLaughlins bottom middle in this picture.

Here's the view out the front, where another Post Residency family (the Galats, see blog on right hand side of our blog) live. I'm sure anyone old enough will be spending a lot of time climbing that tree!This is the McLaughlin front door...And the Fader front door...Here's the McCropder garden, which we decided to jointly hire a gardener for. Fresh produce, coming right up!

This is the Fader kitchen and some lovely women who are cleaning up our apartments for us. They might stay on to help out one of our families when we arrive.

The Fader living room. Looks almost identical to the McLaughlin living room (and I'm assuming, the Cropsey living room as well). You can see Elise in front of the fireplace, too.The bedrooms and bathrooms are pretty standard (flush toilets! running water!). This makes our imminent departure seem all the more real!

Responsibility and Compassion

Yesterday, a chronic low back pain patient sits across from me. "My back has been killing me for the last few days, since I ran out of my meds."

He is one of the few who has the privilege of having a primary doctor, this area of IHS being severely understaffed. "When is your next appointment with your regular doctor?" I ask.

"Oh, I missed my last appointment, and they were going to set another one up for me, and I haven't heard back from them. That was in September." September? That's almost two months ago.

I pause for a moment and try to sort out the right thing to say. I've heard lines like this so many times in the past month. There's a bunch of thoughts and emotions spinning around in my head, and I'm not sure which direction to go.

"Look, I know the system can be difficult, and I know sometimes you might have limited communication resources, but this is your health and therefore your responsibility. If you don't hear back from them, call them. And then call them again. You've had two months. I know it would be nice if everything would be done for you, but it is and will always ultimately be your responsibility."

He nods graciously and doesn't seem overly put off by my miniature rant. I pray for the ability to be merciful as I walk out the door to work on his paperwork.

There's another chart waiting for me at my desk area. "Dr. McLaughlin, this is a patient you had instructed to follow-up today, and he didn't show." He is a new diagnosis of diabetes, and terribly symptomatic from it. There's a form for me to fill out, as to whether I called him or sent him a letter, and what follow up he needs. What does he need? He needs to show up for his appointment! If he doesn't care enough about his own health, why should I? The words of Cain spring to my mind, "Am I my brother's keeper?"

Important aside: Domestically and abroad, the question of how aid work can stifle initiative and responsibility is an important one. I haven't decided whether my actions or my words were inappropriate, in and of themselves. But that's not the point at present. The point is this:

I tell this to Rachel over a dinner of a precious jar of curry we imported from Phoenix, wanting her to agree that I'm in the right. "Hmm, that doesn't sound very compassionate," she says softly. She also reminds me that this is likely to be all the more potent in Africa, where we have been told (i.e. warned) that losing your temper or speaking in anger is the greatest of cultural sins, and is the quickest way to sever ties with Africans.

Paul says "speak the truth in love." I'd like to think that being right is enough, but it's not.

Bob Lynn is fond of pointing out that the Good Samaritan parable was in response to the question "Who is my neighbor?", and Jesus gives the answer that we are to extended neighborliness wherever it is needed. Am I my brother's keeper? Maybe not by any natural right, but as a Christian, I make others my neighbors, and accept the responsibility that comes with that.

I am grateful that I have a month more to work on this, prior to heading to Kenya. Could this be the reason why God brought us here? I won't presume to say, but we're here, and "as long as it is called Today, let none of you be hardened by the deceitfulness of sin."

I found this the other day:

“Oh God of Abraham, please give us humble hearts. Oh God of Isaac, please give us thankful hearts. Oh God of Jacob, please give us faith. Let us see Jesus.”

200,000

One of the many things I was hoping to accomplish before we leave for Kenya was to get our 1995 Toyota Camry over 200,000 miles. Not that I was driving with abandon, but we did preferentially use this car over the past few months. Just in time, we have passed this mark with 5 weeks until our departure. The amazing thing is that the car still has no major problems. As the McCropders plan what kind of car to buy in Kenya to share amongst ourselves, my experience with this Toyota will certainly push me to put my vote in for another one – though maybe a Landcruiser instead of a Camry. I wonder how many miles we can clock on our McCropder vehicle over the next many years. Perhaps not 200,000, since the road conditions can be slightly more challenging in Kenya!