JUBILEE

 

Last minute choir practice.

The big Jubilee celebration has finally come and gone.  On 20^th September, Mutomo Mission Hospital celebrated its golden jubilee, marking 50 years of service to the people of Mutomo and the surrounding region.  It was a massive effort, one which the hospital staff has been planning since January.  In addition to our many African guests, we had visitors from all over the world, including Sweden, Ireland, and U.S.  I saw many friends who I’ve met throughout the year, including staff from CMMB Nairobi (who I met on my first day in Kenya), all my friends from the hospital, from the church, the schools, the surrounding Mutomo community, doctors, priests, international volunteers, etc.  As my time in Kenya is quickly drawing to a close, it was a wonderful way to remember my year in Mutomo and see all my friends celebrating together in one place.

Fellow bass singers Evans (left) and David (right)

Entrance procession.

Procession dancers.

Robert on drums.

The bishops and visiting priests.

Being a member of the Jubilee choir, my day started early at 7am for morning practice.  The Jubilee Mass began after 10am.  It was a lively celebration.  The students from the local schools were present to dance in the opening procession.  As the Bible was brought to the altar, another dancer entered carrying the book in a large pot atop her head.  Two bishops were present to lead the celebration.  The bishop of Embu was the main celebrant, and he gave a beautiful sermon for healthcare workers.  He spoke of the distinctness of every human life, that we are not mere photocopies of each other, but each person a unique masterpiece made by God.  If every person is so valuable, no matter how tired and stressed we are as healthcare providers, and no matter how clean or dirty the patient may appear, rich or poor, we are called to treat each patient with love, to act as instruments of mercy to those who suffer.  His words were very inspiring for the hospital staff present.

The local member of parliament (MP) giving a speech after the Mass.  She herself was born in Mutomo Hospital.

The hospital administrator Sr. Mary Okumu.

The hospital Jubilee choir.  Five long months of practice paid off; we sang very well.  On Monday morning I got a lot of compliments; apparently people in town were impressed and were talking about the white man who was able to sing in Kiswahili.

People waiting in line for food.

Posing with Angela Reuben, our hospital counselor.

Fellow bass singer Benjamin Malombe.

The FEAST!  Delicious meal of chicken, goat, rice, pilau, cabbage, chapati, and bananas.

The altar boys from church being put to work on cleanup after the Jubilee.

After the Mass, the guests of honour were called to the stage for speeches.  Speeches are typical of African gatherings and can last forever.  These only lasted a couple hours thankfully.  After speeches and cutting of the cake, a massive feast was served to all the visitors.

After the Jubilee with Anastasia... I have no idea who that kid is; she just jumped into the photo.

The Jubilee was a big success.  It was simple, but perfect, the way all celebrations should be, filled with good friends and food, singing and laughing and dancing.  We continued the celebrations in the evening, with a group of friends meeting at Stress Free Resort where people danced and laughed some more.

The after-party, with myself, Joel, Dr. Anna Tos (dentist), and Dr. Francis Mutua.

Dancing at Stress Free with Anna Mutua, and Ellen.

Unfortunately the afternoon ended on a sad note.  I was informed by a fellow nurse that a patient I’ve been closely working with for the past week died suddenly during the day.  The patient was a young boy, 20 years old, but he looked more like a 10 year old due to severe wasting.  He was born with HIV, lost both his parents and his brother to the same disease, and was raised by his grandmother.  He was admitted last month with a cryptococcal infection and also tuberculosis, then showed good improvement with treatment and was discharged home on oral meds.  I was surprised when he was readmitted last week, this time with sudden paralysis on the left side of the body.  His viral load (a measurement of the progress of the virus) was extremely high, so he was susceptible to many infections.  Unfortunately, without specific diagnostic tests, we aren’t able to determine what type of infection he might have had.   

He came unable to walk, but made tremendous improvement in the first few days.  He was able to walk again, but still dragged his leg.  His arm was weak, and his hand still remained completely paralyzed.  I spent a long while with him one afternoon going through various physical therapy exercises, repeating them over and over, and making sure he knew how to do them by himself in case of discharge.  As I watched him struggling to even lift his arm, I recall listening to the sound of the students at the next door school running around and playing football outside.  What a contrast to see kids playing and enjoying their youth, and then to see this young boy only a few meters away suffering  and struggling to walk.    As is common with many HIV patients, he also suffered from oral candidiasis, a fungal infection of the oro-esophageal mucosa.  His was much more severe than with most patients, causing him severe pain, even to the point where the nurses would find him in tears.  This was his biggest discomfort, so much so that I had to go into town one day to find some throat lozenges for him at the local chemist (they aren’t stocked in the hospital pharmacy).  His voice became very weak to the point of a whisper.  He also suffered from chest pain, probably due to the TB, and had to sleep in an upright bed at night.   

The standard treatment for HIV is antiretroviral medication (ARVs).  The boy had been taking ARVs for some time, but wasn’t responding so well.  He had to be started on 2^nd-line ARVs.  Besides monitoring his HIV and TB treatment regimen, most of the nursing care focused on managing his pain, and also supplementing hydration and nutrition with oral rehydration salts (ORS) and ready-to-use-therapeautic-food (RUTF).   

Although he was very sick, he was strong and seemed to be making improvement, and I had high hopes for him.  Before the Jubilee celebration, I was at the church for morning prayers and made a point to pray for him.  So it was a devastating surprise later that day when I learned of his death.  While many of us were outside celebrating the Jubilee, he was in his bed, struggling through his last hours.  The nurse reported that he’d developed difficulty in breathing that morning and was put on oxygen, but was later weaned off.  In the final hours his voice became so weak that he had to use a pen and paper to communicate.  Finally he told his grandmother that he was tired and wanted to sleep.  It was discovered shortly after that he had passed in his sleep.

He was a patient loved by the whole ward staff.  He suffered so much, yet never complained about his situation.  He was patient and gentle, yet strong, willing to work towards recovery.  Though his English was limited and I was only able to communicate through my broken Kiswahili, I could tell he was a smart kid.  He had such a hard life.  May he find joy and rest now with God and the rest of his family.

It can be frustrating and discouraging sometimes to work in a place with such limitations.  At home, I am used to seeing illness cured.  Some months ago I was working closely with another volunteer on medical ward, Dr. Layla from Sweden.  We were losing many patients during the month of December, and we were both feeling particularly down.    I recall her one afternoon commenting that we can’t always save every patient; sometimes our job is only to relieve suffering.  I’ve tried to remember her words throughout this year.  With many patients there is little we can do to save them, but I like to think I’ve played some role in easing their suffering.  Despite all the limitations and difficulties of the hospital, I’m grateful for its being here and serving this poor community through the past 50 years.

I’ve seen a lot of death and suffering during my time in Mutomo.  For me it is a reminder of life’s fragility, but also a reminder to make the most of each day, to do good, and to enjoy and cherish every moment.

That being said, let me move now to some very good times I’ve had here in the Mutomo throughout the past couple weeks:

At work with (left to right) Evans, Dr. Petronilla, and Benjamin.

With Sr. Clair, department head of maternity ward.

Hospital staff: Evans, Gilbert, Benjamin, Patrick, and Jane.

My final day working with Benjamin on medical ward.  This week he will be on night duty, and then off duty next week.

Learning to cook with Moses and Benjamin.

Holy Family students at church for Sunday Mass.  I'll really miss these kids when I leave.

Cooking Sunday afternoon lunch.

Learning how Africans do their laundry.

Posing for a victory photo... I finally won a game!

Helping Sr. Esther prepare the night before the Jubilee.

And here are a few fun videos:

One of our choir songs: Hodi Hodi.

 Some clips of me hanging out with friends around Mutomo.

On The Homestretch

One month left!  It’s going too fast.  My departure is just around the corner.  With so little time remaining, I’m trying to fill every spare minute I have, seeing more of Mutomo and spending as much time as possible with my friends.  In fact, my days off work have been busy and more exhausting than my work in the hospital.

The new banner in the center of town announcing the hospital's Jubilee.

Jubilee choir practice.

Wearing our new choir uniform ... they look much better on Africans than on white people.

Dinner with Anita, our new dentist, Anna (center) and her husband Per.

For some reason, the workload in the hospital has been practically zero the last few weeks.  Last month we had almost 30 patients on medical ward alone.  Now we have fewer than 30 in the whole hospital, with only about 8 patients last week on medical ward.  It has made the days extremely boring, but I’ve lately been taking advantage of the free time to work on some new projects.  As I mentioned in a previous blog, I was developing some education materials for diabetic patients.  The process is finally complete.  After a lot of revision, I’ve compiled a small pamphlet to provide to all diabetic inpatients and outpatients.  The pamphlet focuses on basic diet information specific to the local diet, exercise, management of hypoglycemia, foot care, and additional tips for adherence to treatments.  With much help from some of my colleagues, we then translated the book into Kiswahili. 

English and Kiswahili versions of the new diabetic education book.

Instructions in Kiswahili on dieting and other topics.

Foot care in diabetes.

Management of hypoglycemia and exercise.

My next project is to create a very basic education book to teach family members to do physical therapy with patients at home who have had a stroke.  It’s a long way from being an adequate substitute for a professional physical therapist, but resources are scarce here and we’re told the hospital can’t afford to hire one at the moment.  So I figure this is better than nothing.  More to come on that project.

On a recent trip to the town of Machakos with some friends.

Had a visit in Mutomo from the CMMB Nairobi staff.

Rogers teaching me to cook mandaazi in the hospital canteen.

This guy sells sandals in town which he makes from old tires.

Sandals made of tires.

On an outing with the kids from church.

As I said, my activities outside of work have been many.  A couple weekends ago I went with Sr. Celestine from church to take a couple dozen kids for an outing.  We walked a few kilometers up and over the hills to reach Kaseva dam, a local favorite for daytrips.  I carried a backpack full of snacks for them: bags of peanuts, as well as some candies and granola bars sent from family and friends back home.  The kids loved the treats, and it was a novelty having something all the way from America.  While we snacked, some of the kids entertained us with dancing and reciting of poetry/stories in their local language of Kikamba.

Our outing at Kaseva Dam.

Enjoying snacks sent from America.

This small house shelters one mother and 7 children.

Last weekend I went for yet another outing on Sunday after Mass.  Raymond, a member of our church and a retired staff member from the hospital, took our new Swedish dentist, Anna, and me to visit some houses that are being built for the poorest of the poor in the community.  For some years, Raymond has been working closely with Swedish donors to build sturdy, two-room, concrete houses along with an accompanying water tank for families in great need.  The real value is not the house itself, but the water tank.  One of the families we visited consisted of a single mother and seven children, four of whom have various congenital problems: deafness, tremors, mental retardation.  Each day, the children are sent to walk 15 kilometers (over 9 miles) to collect water!  Imagine the time and effort that will be saved by having water accessible within the home.  The houses are designed with iron-sheet roofs which direct rainwater into gutters, which then feed the water into the tank.  We visited another family, also a single, widowed mother with seven children.  This family of eight lives in a tiny mud-brick hut measuring only a few yards in diameter.  The roof is made of grass and has a large hole in it, providing little protection from the cold and rain.  There is only one bed in the home which some of them share, while the rest crowd on the dirt floor to sleep at night.  This is a family which will clearly benefit from having a new home.  These houses cost just above $2,000 each to build, and are completed in only two weeks of construction.  Altogether we visited four families.  Even after so many months living in Mutomo, the poverty can still be shocking at times.

Interior of the above house.

And this is the new house they will receive.

Interior of the new houses.

The kitchen of another poor family.

Foundation laid for the next new house.  It will be done in just 2 weeks.

Using an old thermos and other objects to support the ceiling.

A small portion of the water required to mix the cement.

Beautiful mountains surrounding Mutomo.

Mother of 7 (plus some other visiting kids); 4 of her children were born with disabilities.

The beautiful African sky.

A dry riverbed, with giant boabab trees to the right.

A boabab tree.

Fruit of the boabab tree.  I has a dry, chalky texture, and is a bit sour.  It is apparently high in vitamin C.

Raymond, the man who coordinates for the construction of the housing for the poor.

Dinner with Angela (the hospital counsellor) and Bretta (nurse)

After the long day of touring the new homes, I returned home and immediately set about preparing dinner for a crowd.  Earlier in the week, I had asked a friend or two to come over for dinner.  But somehow, as the week progressed, it turned into a crowd of eight.  It may not sound like a huge crowd, but when you’re working in a small kitchen and with limited water, it becomes a huge task.  It was the largest meal I’ve attempted here: chicken, spaghetti with meat sauce, lentil soup, guacamole, chapatis, cabbage, and chocolate chip cookies. 

Jane (a clinical officer), her husband James (a nurse anesthetist), and Bretta.

The 2 friends I spend the most time with: nurses Benjamin and Moses.

It was a new experience for the guests, as many of the foods were new to them.  They kept eating the spaghetti sauce alone, like a soup.  “No, you’re supposed to eat it mixed with the noodles.”  The chicken was seasoned with rosemary, which nobody had ever seen before, and they kept referring to the bits of rosemary as “trees.”  Everyone was most impressed with the guacamole, and they found the name “guacamole” hilarious for some reason.  All night they kept repeating the word “guacamole” and laughing their heads off over it.  While preparing the chicken, I removed the gizzards and went outside to discard them, only to be chased down by one of the guests who made me bring them back.  She then announced to everyone that I had tried to throw them away… “What!  Why would you throw away the best part?!”  Apparently the gizzards are highly valued, and are often given to the guest of honor at a meal.  Later in the evening, as the chicken was almost finished, the guests began eating the bones!  I never knew they were edible.  I think I’ll just stick with the meat for now.

Dinner with Jane, James, Angela, Bretta, Moses, Me, and Benjamin.

My friends may be learning about Western food, but I am still learning about African food.  A few days ago I was preparing some ugali (the staple food here) for my supper when a friend came to visit.  “What is that?!” he asked, looking thoroughly disgusted.  I told him it was ugali.  “Eric, how can you eat that?” he said.  “If I made such ugali, I would throw it away and start over again.”  And all along I thought I was making it correctly.  He came the next day and gave me a lesson in preparing “proper” ugali.  Tomorrow I’m to gather with friends for yet another cooking lesson, this time to prepare muthukoi, a dish of soft maize with green peas. 

A shop I frequently visit in town.  The owner, Francis, also works as a technician in the operating theater.

Benjamin on an outing to the rocks overlooking Mutomo.

Punda (aka: "donkey) carrying water from the dam.

Visiting the dam with Benjamin, Ellen (daughter of our Swedish dentist), and Yvonne (Benjamin's girlfriend).

Giant cabbages being sold on market day.

Typical shops set up for market day.

View of the stage, where all the matatus (buses) collect their passengers.

Getting a shave at the kinyozi (barber).

Enjoying another game of football with the students of Holy Family Primary.

With two of our church alter servers (and my football opponents): Antony and Daniel.

Having lunch with the elders at GNCA Thome church during  a recent Harambee (fundraiser) to build a new church.

Dinner with Benjamin, Moses, Yvonne, and Kelvin.

Skin grafting for a patient after a snake bite.  It was the first time I've ever seen a skin graft performed.

Dr. Amollo doing the skin graft (with Francis in the background).  Despite being horribly overworked, Amollo can always be seen laughing and telling jokes.

Moses and I meet a few nights each week in the canteen for a game of table tennis.  I seem to be losing a lot lately.

I am having so much fun with my friends in these final weeks.  Saying goodbye to them will be the hardest part of returning home, and yet knowing them has made this entire year worthwhile.

Please continue to pray for me in these final weeks, for the hospital, for the patients, and for the entire community of Mutomo.