2.14.09--Ninapenda mchumba wangu

So it's Saturday morning, Valentine's Day, after our first full week in Eldoret and on the wards at Moi Teaching & Referral Hospital. More on our time at the hospital in a paragraph or two...

We are staying at IU House, a compound that has grown dramatically since my first visit in 2007. IU House is currently hosting what must be one of its biggest groups yet, filling a spacious dining room each evening. Comprised of a large contingent of IU folks in addition to guests from all over the US & the world... students, residents, faculty and their families, people working in medicine, pediatrics, surgery, obstetrics, microbiology, research, public health, engineering, information technology, economics, etc. It has made for interesting answers to the question, "And what do you do?"

It is a kind of oasis from the city beyond its walls. It can be somewhat isolating but the comforts, I think, tend to ease the transition for most guests. There is a crew of friendly guards ("askaris"), who are glad to serve as volunteer Kiswahili teachers, and four playful but territorial dogs. Anne & I share a room in the back corner of the place. Very comfortable, with the small exception of the mosquito that had infiltrated our sleeping net for two consecutive nights... until his demise yesterday. On at least two occasions, I full-on smacked myself in the face in my sleep in an effort to kill whatever it was that had been buzzing in my ear throughout the night... unsuccessfully.

The front door(s)... That's the bedroom/office/living room on the left, and the bathroom on the right.
Our front "yard"...
There is a lovely "banda" on the grounds. That's Anne under there reading something or other.

Located at 7,000-ish feet above sea level and not far off the Equator, the weather in Eldoret is beautiful. A cool breeze takes the bite off the equatorial sun. The occasional cloud floats by... none were available for this picture.


Staggeringly less visually appealling are the sights on the wards. A combination of many things, not doubt, most obviously HIV & the lack of critical care resources leads to an all-too-common experience of watching young people die. I've never felt particularly drawn to critical care. I have often focused on its excesses at home. Just days into my time here, the other side of that coin becomes so very apparent.

A 20-year-old young man admitted comatose two days ago died yesterday with his family looking stoically on. We (I) never had much of an idea as to the nature of his illness. On rounds on the day of his death, we made plans to consult the ICU (All five beds full, refused an actual evaluation, I've yet to see this happen here), ordered two medications that I think we all new weren't available or wouldn't be administered anytime soon, and discussed a Neurosurgical evaluation that he would never be "stabilized" to receive. It was awful.

Other diagnoses aren't as challenging. A tension pneumothorax in a young man with pulmonary TB...
Miliary TB... a common theme thus far. And below, a follow-up CXR a few months after this miliary picture, showing fluid where it doesn't belong.


We are shortly headed to a place called Kerio View, boasting gorgeous views down into the Rift Valley for a date on Valentine's Day. We hope everyone is well.

Mom, be sure to log onto your Gmail account on Sunday morning so I can wish you a Happy Valentine's Day in person.

-Joe