Adventures of an American RN in Kenya: The Church in Africa

Experiencing the Church in Kenya has been such a joy. The name “Catholic” comes from the Greek katholikos, meaning “universal.” Seeing the Church work in Kenya has really demonstrated its universality, its Catholic-ness. It is at the same time so foreign and yet so familiar. Catholicism is relatively new to Africa, but growing rapidly. It was Western missionaries who brought the faith to the continent. Yet in a twist of irony, Africa’s churches are full and ours are not. The Church in Africa has many priests, and yet Western churches often have nobody to lead their congregations. Maybe one day Africa will have to send missionaries to re-evangelize the West.

Beautiful sunset in Mutomo.

Kenyans are an amazingly spiritual people. For being such a small town, Mutomo is filled with many churches, and you can hear their choirs echoing throughout the town all through Sunday. At the hospital people pray before meals, at the start of each shift, before every meeting, etc. And so many people, in addition to their Kikamba names, also take Biblical names or names of saints.

Boy & Girl Scouts

I recently attended an event in Nairobi for Sr. Helen Clare, one of our midwives at the hospital. She was making her final vows as a nun along with five other sisters. It was a large and elaborate event, with hundreds of guests in attendance, a huge feast, music, and dancing. It was much like a wedding, except the brides are marrying God instead of husbands. It was a beautiful ceremony from start to finish. The opening procession was led by a group of boy and girl scouts marching down the aisle, followed by dozens of dancing sisters and novices. When it came time for the scripture readings, a woman danced in while carrying in the Bible in a basket atop her head. The Africans know how to celebrate Mass. Faith and spirituality are exciting for them, and it shows in their practice.

Sr. Helen Clare during her final profession.

Our Lady of Africa Cathedral, Kitui Diocese.

A couple weeks ago I took a short trip to Kitui with the European rotary doctors for a two-day getaway during our days off. Kitui is about two hours from Mutomo and is the capital town of Kitui county. Hendrik (the Dutch dentist) and I traveled there by matatu (the local bus transportation). It is definitely not the most comfortable way to travel. We started the journey with three of us in the front seat. Halfway through, we picked up yet another person. I assumed he would squeeze into the back of the bus, but was surprised when I found him sandwiched between the driver and myself in the front seat! For about half an hour we all sat practically turned sideways until the newcomer reached his destination. In Kitui we met up with the two Swedish doctors and enjoyed hot showers, a good dinner, and live music. At the hotel we also ran into another mzungu, Bram, who is from the Netherlands and is working in Kitui. On Sunday morning, Hendrick and Bram (both fellow Catholics) led the way to the cathedral. It must have been a funny sight to see during the service: Bram with his Dutch Bible, Hendrik and I sharing an English copy, and everyone around us reading in Kiswahili, yet all engaged in the same message. It was beautiful to see the faith transcending cultural and language lines.

Hendrik & Bram

Stations of the Cross in Kiswahili

Crammed in a matatu during the journey to Kitui.

Baptism at the hospital.

Last weekend one our staff members from the hospital’s HIV clinic had a baptism for his newborn daughter. This is the second baptism I’ve attended in Kenya. Unlike at home where baptisms are always done in the church, here the setting is usually much more intimate. Baptisms are often done in the home. This one was done in a classroom at the hospital with family and friends gathered to watch. I’ve kind of become the unofficial photographer for events now. I brought my camera along and was asked to photograph the whole ceremony. So all through the Mass I circled the priest and the baby, taking as many snaps as I could (I was asked to do the same for Sr. Clare’s ceremony last month and took almost 2GB of photos!).

We followed the event with a typical Kenyan feast of rice, chapatti, cabbage, goat stew, and fruit. I’m really loving the local food here. Before I ate it because that was all there was and I couldn’t get Western dishes, but now I find myself craving things like ugali and cabbage and goat and thinking little of American food (though I still wouldn’t turn down a bowl of ice cream if it came my way).

Sunset during an evening jog.

Evans, a nurse from medical ward, shopping for his evening dinner.

The "shoe store" during market day.

All the mothers after delivery waiting to fill out birth certificates

I’ve gotten a lot of practice lately with deliveries on maternity ward. I’ve now done several (maybe 5?) deliveries on my own. Of course they have all been cases without complications and I am never without another nurse nearby who can help if needed, but I’m finally getting the basics. So when I get back to the U.S., if I ever find myself in an emergency where a woman goes into abrupt labor, I think I’ll be able to manage. One exciting bit of news for me this last week: one of the mothers named her son after me. It’s very common here for mothers to name their babies after the doctors and midwives. I felt very honored and told her Eric was a very good name. Still, it’s kind of strange to think that this child will go through life with my name just because I happened to be at the hospital doing the delivery that day.

March 17th, the first baby I delivered on my own!

March 25th: me with baby Eric and his mother.

Baby Eric

Doing fine after vacuum delivery and resuscitation.

We had a delivery yesterday which ended well, but was a bit of a scare initially. One of the patients was in labor, but progressing slowly, so the doctors ordered for her to be augmented with oxytocin. I assessed the fetal heart rate and it was great. About 30 minutes later, I couldn’t find the heart rate when I listened. I asked another nurse on duty to check, and she confirmed what I had heard. I called the gynecologists, who rushed to the ward to see her. We sped the patient down the corridor for a quick ultrasound which showed the fetal heard rate dropping, then sped back up to the delivery room where the doctors did a quick episiotomy and vacuum extraction. The baby had a low initial Apgar of 6. We suctioned out the airway and manually ventilated for a few minutes, and were finally rewarded with the sweet sound of screaming and crying. “Don’t be such a baby!” I always tell them when they cry. Mother and baby were both fine by the end of the shift.

Morning rounds with Dr. Amolo, the chief medical officer at the hospital.

We seem to be resuscitating a lot of babies lately. Earlier this week we delivered a baby by caesarian section and ended up having to intubate, ventilate, and do compressions for almost an hour. He spent the night on oxygen and under close supervision. He’s done great all this week, gaining a good deal of weight and breathing without any difficulty. This morning, four days after delivery, he was discharged home with his mother.

Thank God for eye goggles! Note also the bloody hands!

In a recent care package from home, I received a pair of protective eye goggles. They are such a godsend, as I sometimes find myself speckled with blood and amniotic fluid and always worry about getting the stuff in my face. Thank you Mom and Dad! Don’t need any of that amniotic soup in my eyes.

Mutomo after a heavy rain.

Every Thursday, the hospital has continuing education classes put on by staff members at the hospital. This week I volunteered to present another lecture, this time about palliative care. Palliative care is a specialty area of healthcare that focuses on quality of life and controlling symptoms of a disease, rather than curing the disease itself. Clinicians and nurses at the hospital often use the term “palliative care,” but many don’t necessarily understand what it means or how to implement it. Coming from an oncology unit back home, I had a lot of experience dealing with palliative care, so I decided to give a class on the subject. People seemed generally interested in the subject (even though it may not look that way in the photo).

Assembled for my morning lecture... don't they all look so excited?

This girl kept up for a good while during a morning run.

Now that I’ve been here for a good amount of time, I often find myself forgetting that I’m different from everyone else. Not that I think of myself as African; I just forget that I look different. I used to be very alert to the stares every time I stepped into town or went to church. I was always painfully aware of my foreign appearance and how alien my white skin must look. Now when I’m walking around town, I occasionally notice people looking at me and I remember with surprise, “Oh yeah, I’m white!” The children never get tired of staring and waving at me. You would think I was walking through town dressed as Santa Clause the way they all run up to me. I like to go running through town a lot, but I hardly ever have a run without a group of kids chasing after me. Usually they yell, “Mzungu, mzungu!” although the latest one I’ve been hearing is, “British! British!” Their standard greeting is always, “How are you?” I think this is the only English phrase many of them know, because when I answer, “Fine, how are you?” I often just get confused stares.