A Day at Our Clinic

~ by Michelle Kiprop
ELI Family Nurse Practitioner


While studying to become a nurse practitioner, I chose to specialize in Family Practice because I figured in this setting I would see just about everything. And boy was I right! I’d love to write about our typical day but I’m not sure we really have one...

I’m the only American at the clinic; the rest of our staff are amazing Kenyans with a boatload of experiences. We have two highly trained RN’s, a Clinical Officer (very similar to a physician’s assistant), a dental technician and a laboratory technician.

On Tuesdays and Thursdays we provide antenatal care and do well child immunizations. We typically have many malaria cases throughout the year. The clinic staff cares for patients from all walks of life and with many different types of problems. We may see a 2-month-old baby and then treat the grandmother who brought her in the same visit. One of my recent weekend clinic adventures was suturing up machete wounds from a domestic dispute.

Our clinic theme is “We treat, God heals”.

One of my favorite aspects of working in the clinic is helping the mama’s deliver babies. Last night was one of those special nights. A little after midnight I got the phone call “She is fully dilated and getting ready to push, you better come now.” William, my husband, got up with me to go to the clinic. We put on our gumboots (rain boots) and tromped through the mud using our flashlights to get to the clinic.

The patient was a 16-year-old I had been following in antenatal clinic. When I walked in the room the mama broke out in a huge smile and thanked me for coming. That moment alone was worth the midnight trek through the mud. If my presence could induce a smile like that at full dilation, the trip was most definitely worthwhile. Bernard, the nurse on call, declared that as I had followed her all the way through, I should be the one to deliver the baby. Thus far I’ve only assisted but haven’t actually taken the lead. Bernard coached me through step by step. I couldn’t have done it without him. And by the way, I still consider myself to have assisted in the delivery. I don’t think we medical professionals should get the credit for delivering the baby when it is the mom who does all the hard work!

Somewhere between 1:30 and 2:00 Karen Jemutai made her grand entrance. It was a difficult delivery with some minor complications. But I’m pleased to announce that both mom and baby are doing great this morning. What a joy it is to watch a new baby take her first breath and scream out her protest as she enters this world. Then those little eyes start blinking and taking it all in. Those first minutes are so precious. Mom and gogo (grandma) thought that I should name the baby. They asked me if I wanted to name her Michelle after myself. I told them that I was honored but I thought the mom should choose. Mama and baby Karen stayed overnight and are getting ready to walk home as I type. That’s right! Just eight hours after delivery mom wraps up the baby and walks her home.

Life in rural Africa is very, very different from life in the US!

Services offered at the Chebaiywo Clinic includes the following:
1. Curative (The treatment of injury or illness of just about any type i.e. from sprained ankles to malaria)
2. Laboratory Services (including HIV testing and counseling)
3. Maternal Health, Infant/Child Health, and Family Planning
4. Basic Dental Services (Usually resulting in tooth extraction)
5. Preventative Services: Sale of Mosquito nets and Water Guard (kills parasites and bacteria from well water to make it safe for drinking)
6. Outreach Services: Mobile Clinic (We literally take the clinic on the road to a remote location)
7. Reproductive Health Training Sessions (focused for local midwives)
8. Pharmaceutical Services
9. Maternity/Deliveries

The Gap

~ by Juli McGowan, ELI missionary

It wasn't even 7 am yet, but the line of people outside of my house reminded me of the gap between what is and what should be. One man introduced himself and explained he had walked several miles to meet with me. He shared of struggles in his family and his challenge to pay his children's school fees. Another told of a sick person needing treatment who was unable to afford it. The third explained that he needed advice in how to deal with some challenges. As I walked away, I began to pray. Rather than allow the burdens to overwhelm me, I asked God for His perspective. I didn't have the answers or solutions to these problems, but I knew that God was present. So, I asked Him to show me how to live this day, to love with a love that is greater than myself.

Later this morning, I arrived to the training center and began to tabulate the results from our Tumaini na Afya (Hope & Health) AIDS Awareness Campaign that was held on Saturday. It was an amazing day. A couple thousand people attended and just over 800 people learned their HIV status. Although a majority of the people who tested were men, 95% of those who tested positive were young women. This revealing, once again, not that women are more promiscuous than men but simply more vulnerable. Yesterday I visited a young 20 year old widow of two weeks named Emily whose story represents this so clearly. She married her husband only a year ago. He had worked as a truck driver along the trans-African highway. His first wife had died in 2002 leaving behind two children. Emily learned that she was HIV+ several months ago while she was pregnant. Unfortunately, she did not receive treatment and breastfed her baby. As I sat and listened to her share her story, I was deeply saddened. HIV has stolen and destroyed the lives of too many in this young family. Once more, I didn't know how to comfort this grieving lady; but I prayed to the only One who is able to restore hope to the hopeless.

Things are not as they were meant to be. I know this quite well. But I also know that God is with us. These lyrics, written by Tommy Walker, that say "Sweet Jesus come. Sweet Jesus come. Sweet Jesus come to me. Come set my spirit free so I can worship thee. I want to sense your power and love at work in me. Sweet Jesus come" have so often been my prayer. Today Jesus did come and present himself in the form of a hungry man. He came as a father who doesn't know how to provide school fees for his children. He was in the widow who feels alone and in her baby who is struggling to live. He was in the crippled man sitting outside my window repairing our children's shoes. Jesus has come right to where He said He would be. With an open invitation for us to draw near to Him, we enter the gap between what is and what should be.

Home-based What?

One component of ELI's ministry in Kipkaren is called Tumaini na Afya - Health and Hope. And part of this health ministry is to care for the sick and the suffering in their homes. Whether it's patients suffering from HIV/AIDS-related issues, or families who are living in desperate situations, the home-based care team goes to visit them, encourage, support where they can, pray for them, simply show them, in tangible ways, the love of Christ.

Last week, 50 new caregivers underwent a 5-day training at Kipkaren. Attendees came from as far as Nairobi. During their graduation, Allison encouraged the group by telling the story of the first person she and Juli went to visit: Timon. Our friend Timon has since passed away, but since that visit just three years ago, countless lives have been touched. Others have been trained to do the same.

"Tonight, you receive a certificate," Allison reminded them. "But this is just a piece of paper. It's worthless, really. The way you'll touch lives is by going to visit the sick, the dying, the hurting. It all starts with just one visit..."

ELI Director David Tarus, praying for the students

David, Allison and Juli handing out certificates to new graduates

Students giving each other high 5's after graduating, saying,

"Together, we are defeating AIDS!"

To get a glimpse of some of the work the home-based care does, read some of these entries.

AIDS campaign - Thanks for praying!

Thanks so much for your prayers for last Friday's AIDS campaign! We had a wonderful campaign full of many successes including the following:

• No rain! Lots of sunshine (with no trees to hide under resulting in red faces, necks, and arms for us two white people--Juli and I)!
  
• Tons of people--between 6,000 - 7,000
• Lots of entertainment from many different groups ranging from school children to grandmothers, all singing songs about HIV/AIDS
• Exciting games including two bicycle races and a challenging football (soccer match) which ended in penalty kicks
• Collaboration among several organizations working in the area including: ELI, AMPATH, Ministry of Health, Deliverance Church, and the host organization, Agriculture Development Corporation
• Important messages of hope passed to the crowd from HIV+ individuals, government officials, chiefs, senator of the area, and all organizations involved in the day
• Testing, testing, testing!!! We had 20 VCT counselors set up in 3 tents who worked very hard all day long in the hot sun. At the end of the day, 748 individuals faced their fears and took courage to be tested and know their HIV status--419 men, 262 women, and 67 unknown (meaning we did not get the exact data of the 67 individuals). 3.5% of those tested were found to be HIV+ and were referred to the nearest AMPATH clinic for further counseling and treatment
• We have already started planning for our next big campaign, which will be held on Friday, April 20 in the village on Natwana. Thanks for joining us in the fight against HIV/AIDS...replacing fear with hope!

Blessings,
Allison and the entire Tumaini na Afya Team