Give Thanks

"Enter his gates with thanksgiving and his courts with praise.  Give thanks to him and praise his name.  For the Lord is good and his love endures forever."  Psalm 100

As you can imagine, being in Kenya for 5 weeks has made me more aware of the blessings that the Lord has so graciously given me.  I have been surouded by a community of people who are truly grateful unto the Lord.  Many of whom we back in the States may look at and wonder what exactly they are thankful for.  I am touched by the humble hearts of those here at Tenwek, and the fact that any blessing, no matter how big or small, is understood to have come straight from God. 

I have many things to be thankful for this year.  I decided to share some of them so that the one who gave them to me can get the recognition and praise that he deserves. 

• Salvation in Jesus Christ.  Lord knows I fall short every day, but his mercies are new every morning.
• Mark.  I'm not sure why God chose to make him mine, but I am so glad that he did.  I am constantly in awe of the man that my husband is and continues to become.  Serving together in Kenya has been yet another reminder of his generous heart and his selflessness. 
• My family.  Unconditional love, that is what they give to me.  What comfort in knowing that no matter what is going on in life, I can always go home.  I am also thankful for the opportunity to extend my definittion of family when I married Mark, giving me even more people that love me and make sacrifices for me. 
• My friends.  I am one blessed girl! I truly have the best friends anyone could ask for.  I believe that their love for God enables them to love me more fully.  I can honestly say that I have friends that would put my needs before theirs, how comforting!
• The Physician Assistant Program at UK and my Classmates.  I am thankful to have the opportunity to educate myself and persue a profession I love and that will allow me to help others.  It has also given me the opportunity of a lifetime here in Kenya.  And my classmates? Well, praise God for them.  Its no secret that I tend to stress, but having them to remind me to "get it together" and have fun has not only gotten me through countless marathons of studying, but have made the process a very enjoyable one.
• Cooper.  I truly believe that God has blessed me through my dog.  He never fails to bring a smile to my face.  Any while sometimes I get annoyed that he ALWAYS greets Mark at the door and usually greets me, he will always be our first child.
• My sister.  Lindsey was in a car accident the morning of Thanksgiving while driving home in the early morning after a night at work.  And while her car was likely totaled, my sister was not. I will count this my greatest blessing.  Praise God for keeping her perfectly safe in the palm of his hands.  What joy to know that he still has great things in store for her.

The above is by no means an exhaustive list of all my many blessings.  I guess you know you are really blessed when you have to cut your list short.  Being in Kenya has reminded me to be thankful for other things that I might usually take for granted...a roof over my head, transportation, food, access to healthcare, clean water, clothes, and the list goes on.  Thank you to all who read this blog.  Many of you have blessed Mark and I by your prayers, encouragement and financial support for this mission trip. I pray Gods blessings on all of you and I hope you had a wonderful and very happy Thanksgiving!

changes

Well, there are a lot of changes going on here at Tenwek.  Yesterday, Kelly and I completed our last day of our Women's Health rotation.  And although I don't see a furture for me in OB/GYN, I am going to miss all the staff on the OB floor.  And even though it was our last day, it prooved to be our most eventful.  Kelly and I each got the opportunity to be first assist in a cesarean delivery AND close.  I haven't sutured since my ER rotation, and I haven't done a subcutaneous stitch since we practiced on pigs feet in class, but thankfully I had good instruction at UK and it came back pretty quickly. 

I contemplated not sharing a particular case with you, but as this has been a learning experience for me, I thought I would share.  As you can imagine, not every day on the OB floor is a particulary happy day.  Here, the people do not have access to all of the imaging and diagnositic testing that we are priveledged to have in the states.  For example, back home, pregnant mothers have something called a Quad Screen when they are 16-18 weeks pregnant.  This test will tell the physician and family the risk a patient has for delivering a baby with Down syndrome, Edwards syndrome, or nural tube defects (NTDs).  I can only imagine that by conducting this screening, it can better prepare families and physicians for dealing with a child that may have specific needs once he or she is born.  Many of the patient's here never receive an ultrasound during their pregnancy.  Sounds crazy, right.  Families in the states look forward to finding out the gender of their baby.  Women here will only have an US if their is uncertainty about the gestational age of the fetus or if a problem arises.  The patient who's surgery I helped with yesterday had received an ultrasound that measured her babies head much larger than it should be.  Again, without access to all the diagnostic tests we have in the states, we had to assume the possibility that this baby had hydrocephaly.  A form of nural tube defect where an abnormal amount of cerebral spinal fluid builds up in the cavities of the brain.  This condition can cause all kinds of developmental problems and even death.  So there I was, scrubbed in on a C-section that may not have a happy ending.  One thing I love about Tenwek is that we pray with our patients before every surgery.  I have even had the opportunity to pray for a few of my patients. So of course we prayed for this mama, and as we all need prayer, I couldn't help but think this mother and child needed it most.  So we did the surgery and this baby did indeed have hydrocephaly.  I won't go into too much detail, as some of you reading may not do well with medical graphics, but the increased size of this infants head made the delivery much more difficult.  I had to put all of my weight on the mother's abdomen to try and maneuver the child out of the incision that had been made.  Upon further evaluation, the infant had a meningocele.  This is more commonly referred to spina bifida.  Here, an unfused portion of the spinal column allows a portion of the spinal cord to protrude.  There is usually some degree of paralysis, and infections are very common.  As of today, the baby is actually still living and breathing on his own.  NTDs are usually caused by inadequate amount of folic acid in the mother.  The nural tube has developed by the time a woman misses her first period and therefore before she even knows she's pregnant, so the recommendation is for every woman of reproductive age to take 400 mcg of folic acid daily espeically those who want to conceive within three months.  I asked my preceptor if these women have access to prenatal supplements.  He stated that there is a theory that women who live in countries with a corn based diet have greater incidences of NTDs that is possibly due to a folic acid antagonist found in the food.  Interesting.  Please keep this mother and her child in your prayers.  We serve the mighty healer.  Yesu anaweza- God is able.

On a different note.  Today is Mark's last day in the physical therapy department at Tenwek.  He will be headed back to the States on Monday :(  Several of his co-workers have asked Mark to become a full time missionary here! (don't worry family, we aren't planning on it)  They love him, and who wouldn't :)  I have gotten to watch Mark interact with the people here at Tenwek and it has been absolutely amazing to see how God has used him.  Mark has a special gift of making those around him feel special and happy.  Doing missions in Africa has always been one of my dreams, and now I think Mark would agree that it has become a passion for him as well.

As for Kelly and I, we will start our new rotations on Monday.  Kelly will be headed to pediatrics and I will be headed to general surgery.  Please keep us in your prayers as changing rotations, especially in a different country, is usually accompanied by some anxiety.  Thanks for your continued prayers and words of encouragement.  Please remember Mark as he makes the long journey back home by himself.  God Bless!!

Yesu anaweza

Today we had another wonderful service at the African Gospel Church.  Praise and worship time was especially awesome.  We sang some songs in English and some songs in Swahili.  While some people may find that languages such as Itialiano or French are pleasing to the ear, I find myself drawn to the beauty of swahili.  Today I learned "Yesu anaweza" which translates, "God is able". 

Today, the pastor talked about finding our spiritual giftedness.  I believe that everyone has something to offer to the Lord to help further his kingdom and bring those who are lost to salvation in Jesus Christ.  The key is in finding out what area you can best serve the Lord.  Sounds easy...but is it?  I find that often we are better at finding the areas that God has blessed others.  "If I could only sing like her I could use my talent to witness to others."  "If I were as comfortable speaking infront of crowds like him I could lead others to Christ."  Do you see what I mean?  Have you ever said some of these same things?  Its also easy to assume that if God really wanted you to do something, it wouldn't be so difficult.  I'm sure Moses felt the same way.  In Exodus 3, the Lord tells Moses to go to Pharoh and ask for the release of the Israelites.  Moses asked, "who am I that I should go to Pharoh and bring the Israelites out of Egypt?"  The Lord responded with, "I will be with you."  In chapter 4, Moses raises his concern about being "slow of speech and tongue".  The Lord replies, "Who gave human beings their mouths?  Who makes them deaf or mute?  Who gives them sight or makes them blind?  Is it not I, the Lord?  Now go; I will help you speak and will teach you what to say."  What comfort!  God doesn't ask us to go blindly, but to step out in faith with the knowledge that he will be right there with us.

I am still searching for my spiritual giftedness, but I pray that as I seek God, he will make it known to me.  Today the pastor said something that I thought was important.  He said, "Great things are done through people who say 'yes' to God and make the neccessary adjustments."  Saying "yes" to God requires a change, and change is not always easy, nor is it comfortable.  But remember, Yesu anaweza....God is able.

I challenge all of you reading, as well as myself, to ask God to reveal your spiritual gifts so that you can play a part in furthering his kingdom.  We love and miss you all, God Bless!!

-Emily

Generous Hearts

My preceptor for my Women's Health rotation, Dr. Carrie Huber, allowed me to borrow a book from her called "African Friends and Money Matters."  The purpose of this book is to try and bridge the gap between Westerners and Africans by explaining cultural differences and reasons behind their (and our) ways of thinking.  In being here only 3 short weeks, I see the need for a better understanding of the people I now encounter on a daily basis, in hopes of being able to meet their needs more completely.

I know many of you reading this blog have seen the show "Hoarders".  Some of you may even be self-proclaimed acquirers of this trait.  Lets also include the show "extreme couponing," because although being smart with your finances is an admirable trait, it can lead to hoarding of things like toothpaste, dish soap, laundry detergent, etc.  While Americans seems to "need" more and more, Africans see possesions in a different light.  Here, it is a general rule that people expect that money and commondities will be used or spent as soon as they become available.  If their is no immediate need for the resource, there is always someone who could benefit from it (family, friends).  Holding on to an resource without using it is considered hoarding and is considered unsocial.  In thinking of shows like those mentioned above, its easy to see the excess...who needs 25 tubes of toothpaste!  But when we examine the lives of those who maybe aren't as extreme, I'm sure we can still find areas of excess and "hoarding".  For example, off the top of my head I can recall that back home I have 2 glass measuring cups (exactly the same), 2 sets of plastic measuring cups, 3-4 mixing bowels, 6 other bowels that I never use because they don't match the others, and more cups/glasses/mugs than 2 people could ever need.  And this is just in my kitchen!!  In Africa, "surplus" cannot be separated from "selfishness".  In this thinking, there certainly must be many in the family who are needy and deprived, and if you were fulfilling your family obligations, you wouldn't have acquired so many goods.

Another lesson I learned from this book is that Westerners are more charitable than we are hospitable.  Africans are just the opposite.  As westerners, we are more likely to make a financial contribution to organizations like the Red Cross, but are also more likely to get annoyed when a visitor stops by our house at meal time.  Africans are less likely to make charitable donations, but are more likely to invite you into their home and spend time and whatever resources (food, tea,etc) they have with you.  We have only been here 3 weeks and Mark and I have already experienced the heart of hospitality the Kenyan people have.  Solomon, the physical therapist at Tenwek that Mark has been working with, just invited us to his house to eat and then teach Sunday school at his church!  A nursing student that I have been working with for a few days invited me to her family's house in Bomet for tea.  And you can even see this influence on the long term missionary families here at Tenwek as we have been given countless invitations to their homes for meals. 

I think the culture here is starting to rub off on us as well.  I have a patient on the OB floor who has recently been diagnosed with an epigastric mass.  This patient desperately needs surgery, not just because of the symptoms she is experiencing daily due to this mass, but also due to further complication in the fact that she is pregnant.  Many of the patients we have encountered here are anemic, and this women is no exception.  She requires a unit of blood before surgery as well as 2 other units of blood for during and possibly after the surgery.  Her blood type is O- and just like in the U.S., this is a rare blood type that is also highly desired by blood banks because it can be used in transfussion for a person of any blood type.  The blood bank at Tenwek often runs low and patients are often asked to bring a family member that can donate a unit of blood for them.  This patient has brought in 12 different friends and family, none of whom have matched her O- blood type.  Her surgery has been delayed until she can get 3 units of blood.  Guess who I know that has O- blood?!

That's right, my husband, Mark Gibson!  I think we were both a little concerned at first because the words Africa, blood, and needles, bring to mind HIV and other blood related illnesses.  However, many of the missionary doctors here donate blood as often as they can.  I personally watched the procedure and feel very confident in their supplies and techniques.  Mark willingly gave what he had in excess so that my patient can get the surgery she needs.  More good news is that another patient that had O- blood on hold incase it was needed during their cardiac surgery is probably not going to need their reserve blood and will give it to my patient so that she will have the 3 units of blood she needs....there again is an example of that African attitude of giving to others in need.  Praise God for their generous hearts and the heart (and blood) of my husband :)

The Wild Side...

This past weekend, Kelly, Mark and myself had the privilege of going on a Maasai Mara Safari along with our new friends also visiting at Tenwek: Seth, Laura, Shelly, and Barbara.  We left on Friday and stayed until Sunday.  What a great time we had!!!  We had been told that this place was nice, but we had no idea what to expect.  Our housing for the weekend were tents.  Now these aren't the tents we are used to in WV and KY.  Mark and I felt like we were on a second honeymoon.  See some pictures of our room below. 

When we first walked up onto the porch of our tent, the first thing we noticed were the hippos in the river just outside of our tent.  These hippos provided loads of entertainment as they were very vocal and playful.  Each morning we were awakened by someone coming to our tent with coffee and hot chocolate.  We would go on a morning and an evening safari.  Once we got back in the evening, there would be a hot water bottle in our bed keeping it nice and warm for us.  Talk about service!  The meals served by the resort were amazing and included things like steak, lobster, and lamb.  Laura and I even had the luxury of an hour long full body massage during our stay.  It was much appreciated, especially after the bumpy "roads" we traveled to get to the resort and then out on excursion!  All the staff at the resort know you by name.  I have never been treated with such service.  It was truly an amazing experience. 

As for the Safari...we saw all kinds of wildlife!  We saw rhinos, hippos, leopards, lions, giraffes, baboons, zebras, worthogs, topi, a cheetah, cape buffalo, all kinds of different species of antelope, jackals, hyenas, etc.  We even got to witness a cheetah trying to chase down a baby antelope...however, mama antelope stepped in a scared off the cheetah, it was amazing. It was interesting to watch all the animals stand still and keep their eye on the cheetah.   It was also interesting to see a lot of the animals grazing in the same fields.  You would see a giraffe surounded by zebras and antelope, all living harmoniously together.  Although giraffes were not an uncommon site, I never got tired of seeing them.  I am still amazed by their size and surprising elegance. 

Once again, I am reminded of the size and power of my God.  How creative he must be to design all these animals.  Each with special skills and characteristics that help them survive in what can be a hostile environment (as we saw with the cheetah).  The Maasai Mara is so vast and so beautiful, you can see God's brush work through a beautiful sky, a rainbow following an afternoon rain, a perfectly placed tree, or the amazing camoflauge of the animals.  Our group was reminded of the Garden of Eden and what an incredible place it must have been for Adam and Eve to begin life.

 




Cheetah, resting after the chase

 






So grateful to share this experience

  



"The earth is the Lord's, and everything in it."  Psalm 24:1



"My mouth will speak in praise of the Lord.  Let every
creature praise his holy name for ever and ever."
Psalm 145:21

  


Mark's birthday celebration!  African style!  Hopefully one he'll never forget!