Tuesday, November 16, 2010

Nail House???

One of the first things I did upon arriving in Kenya in September, was to start working on getting my work permit. I am currently allowed to be here because of the tourist visa I purchased through Customs in the airport ($25). A tourist visa is good for 3 months, at which point you can purchase a 3 month extension. After that, it’s technically illegal to be here without some kind of permit. The work permit can be valid for up to 4 years. So…I heard I was going to the ‘Nail House’ where the Immigration Office is to work on this. One of my male teammates told me he had a contact person there that helped he & his wife go through this process. He referred to her as “his ‘Nail House’ lady”….funny comment from a guy! Well, when we got there, I quickly learned that my ears aren’t quite tuned in to Swahili yet. It’s actually the ‘Nyayo House’. My bad:)

Here’s a step-by-step process I’ve gone through so far for getting my work permit…it’s one that tests your patience!
• Submit the application along with: 1) a letter from AfricaHope stating I’m volunteering with them & requesting I be issued a work permit, 2) at least 3 letters of recommendation from non-family members (thank you to those that wrote wonderful letters for me!), 3) copy of my birth certificate, 4) copy of my passport, 5) 10 passport sized photos, 6) copies of my diplomas, & 7) résumé.
• Wait…& wait….& wait…until the work permit has been approved.
• I went to check on the status of my work permit when I got back from Ethiopia. Stand in Line 9. I finally made it up to the counter & handed the lady my receipt from when the application had been turned in. She needed a reference number to be able to check. Go to Room 16.
• Wait in line…get the reference number…back to Line 9.
• Wait in line… When I made it to the counter again, I opened the folder with all my paperwork in it to hand her the receipt. It was gone! I started frantically looking. The guy behind me said he had seen a paper on the ground, but didn’t know where it went. I couldn’t find it! Back to Room 16.
• Get reference number, again. Back to Line 9. And wait….
• Third time’s a charm….when I finally made it to the counter again & gave her my reference number, she said it had been approved! Woo hoo! That was record time! It has taken months & even up to a year for other teammates to get their permits approved...my application was approved in 1 month!!!
• Back to Room 16…again. The lady there found the official document that said my work permit had been approved.
• Go to the Cashier’s desk. I was informed that I had to get a ‘Security Bond’ from either an insurance company or bank, & bring proof of that to him.
• Day 2…Security Bond. Turns out, I had to have an official AfricaHope stamp for the security bond paperwork. We had to have it sent by matatu (taxi) carrier from Narok to Nairobi first thing that morning. Then, off to the insurance company.
• I was very confused as to what a ‘Security Bond’ was, & no one at the insurance company was explaining it in a way that I understood. I heard the word ‘bond’, so I thought it would function like a bond in the States & I would get that money back after 4 years (paying 20,000 KES [about $250] for a bond valued at 100,000 KES), but I was informed I wouldn’t be getting that money back. I was determined to find out what this ‘Security bond’ was since it was so much money! So...I attempted to read the small print of the contract. It’s basically insurance for the Kenyan government against me! If I do anything while I’m here that costs them money, this ‘Security bond’ will cover it up to 100,000 KES ($1,250)…evacuation, medical, damage, etc. Interesting…
• Back to the Nyayo House. I showed the Cashier my proof of Security Bond. I then owed around 6,000 KES ($75 processing fee). He gave me a receipt & said to come back in 2 weeks & go to Room 16. Why not now?! Why 2 weeks if it’s already been approved & I just paid for everything?!
• I went down to Room 16 to check for myself. “Come back in 2 weeks”… So close yet so far away!
• I’ll be checking on it this Friday. If it’s ready, then I’ll apply for: 1) a re-entry permit (so I don’t have to buy a new visa each time I re-enter Kenya), 2) an alien card (so I can get Kenyan citizen prizes on things, especially the tourist attractions!), & 3) a Kenyan driver’s license. Prayers appreciated:)

Thursday, November 11, 2010


I wouldn’t say I’m a fan of motorcycles. They make me nervous. Having been in the medical profession for the past 7 years, I’ve heard about way to many motorcycle accidents for me to not think twice about getting on one. That being said…I tend to have temporary lapses of judgment when visiting foreign countries:) It first happened 3 years ago in India with my sister & cousin… Our driver decided that we would love to each ride on the hotel motorcycle on the narrow mountain road to go see a cave temple. My sister went first… no problems. My cousin refused…so smart! It was my turn. I got on the back of the motorcycle…& then immediately asked myself, “What in the world are you doing?!” I started to pray. And then the motorcycle died!!!! I couldn’t believe it! They had to tow it back to the hotel with someone holding on to the rope it was tied to sitting in the back of the car! Thank you, God!!!

Then came Ethiopia… motorcycles were one of three transportation options (walking 45+mins & bajaj being the others), but the only safe option at night. So…I hopped on…and started praying. The motorcycle never died…the whole time I was in Ethiopia for that matter. That gave me peace. Guess God thought it was okay this time:)

Wednesday, November 10, 2010

6-weeks in Ethiopia....

Sit back & relax…this is a long one:) Here’s my best attempt at describing my 6 weeks in Ethiopia…

Picture frontier living back in the 1800s…simple, but hard living. Horse-drawn carriages. Farming by hand. Cooking over a fire. Close communities & families working together to survive. Then someone walks by a grass hut, all the while talking on their cell phone. Trucks & mini-buses emit horrendous fumes as they drive by on the roads lined with pedestrians & donkey’s pulling supplies. You see clothes from the US, but they’re well-worn, stained, & torn. Life in Ethiopia…well, most developing countries, is full of these paradoxes that are hard for my brain to mesh together. And then to top it off…you’re a celebrity! Foreigners, especially white people, are still a rarity, so your each & every move is watched. Kids want to test their English on you & try to touch your skin or hair:) Now that you have that visual…

I lived in an area called Otona outside the town of Soddo, which is about a 5-6 hr drive southwest from the capital of Ethiopia, Addis Ababa (the 2nd highest capital in the world!). It was absolutely beautiful & not at all what I expected…it made me think of Hawaii, Colorado, & Vermont:) Soddo is a town of about 50,000 people that sits at an altitude of 6,800 feet. The national language spoken around Soddo was Amheric, along with the local language of Wolaittina. The area is predominately Christian…Orthodox & Protestant. There was also a Muslim. When I arrived, it was the tail end of rainy season, & was beginning to move into dry season. It was generally in the 70s-80sF during the day with nice, refreshing rain showers at least once a week. As the wind storms began, I was told it was a sign of the approaching dry season. The mud dried up, leaving lots of red dust.

I lived in the house of the missionary I filled in for (Sophie) just a couple houses down from Dr. Mary (the missionary doctor I worked with) & her husband, Gary. They live in a compound that was built for SIM missionaries back in the 1950s, but is now owned by a nearby Protestant church & is used as a Bible college. The house looked like it was transported from 1950’s American, but with some African touches:) There was even an American style attic…which was probably one of the last things I expected to see in Africa!
For my first 1.5 weeks, we had no running water because of a busted water pump in town. Donkey’s brought the water from the river/spring about a 5-10 minute walk away, where most people did their laundry & others brought trucks & motorcycles to be cleaned in the river. Water was always filtered & boiled before consumed. When the water came back, I think I was happiest about the flushing toilet:) Oh, & the hot shower…that 1 hot shower…before the water heater broke:( So, then I was back to taking bucket baths with hot water heated by a wonderful electric kettle…cold showers & I don’t mix well. The hot water heater did manage to get fixed before I left, but not before there was a waterfall in the living room & kitchen caused by a leaking pipe valve in the attic. The electricity was pretty sporadic… it went out for at least a couple hours (mostly in the evenings) about 4-5 days/week…more frequent than in Kenya. I ate many a dinner by candle light:) There was one day it was off for over 24-hour, which defrosted the freezer for me…look for the positives! There were also frequent power surges, so most things had to be plugged into a surge protector so they didn’t fry. And then there were the fleas that appeared in the living room…quite the battle! Sophie said she’d never had that many problems with her house before. So…this was just my initiation into African living:) I feel like I lived out a ‘Living in a Developing Country 101’ course:) Gary & Mary were so great about teaching & showing me things…how to flash ‘pasteurize’ local fresh milk, water filters, electrical problems, local meat shopping/cutting/grinding/freezing, passion fruit juicing, good from-scratch recipes,
good plants/herbs to grow in the garden, how to clean vegetables & fruit you’re going to eat raw with bleach, tips for the slow internet, etc. Then there was the adventure in the bathroom after Sophie returned & Angie arrived…declogging the shower drain & caulking! I also learned a lot just by living in Sophie’s house & seeing what she had there after living in Ethiopia for a little over 1 year now. God brought me to Ethiopia to learn a lot more than rural medical clincs:)

Most mornings, I was up by 8am to welcome the house help. I was so thankful for them…Amarech, Zenabu, & Tsaganesh. It takes about 10 times as long to get normal, everyday things done (laundry by hand, dishes by hand, cooking from scratch, gardening/mowing with no machines), that I would have had trouble having time to do anything but live without their help. Plus, these jobs are a normal part of their culture. There was a gas & electric stove & electric oven in the kitchen, which I became very well acquainted with. One of the quickest meals was pasta. There was tons of pasta & tomato paste around town thanks to the presence of Italians pre-WWII.
Zenabu helped with the garden out back, growing lettuce, spinach, onions, turnips, strawberries, passion fruit, & rhubarb growing along with some avocado, custard fruit (or bread fruit), papaya, & guava trees. Zenabu & Tsaganesh were both also in school when they weren’t working. Tsaganesh was the only one of the three that spoke much English, so all of my communication was through her. She enjoyed listening to Ethiopian music (what sounded like a mix of Middle Eastern & Indian music) on her cell phone while she worked:) (Random note: I heard quite a bit of American music in restaurants that was a blast from the past…Bryan Adams, Shania Twain, Warren G…random tunes that would catch me off guard & made me smile:)) One other friend that helped out a lot was Kebede…he just finished his first year of nursing school & works at the Christian hospital in Soddo when he’s not helping translate for short-term teams. He would help me find what I needed around town, & then would take me back home on a motorcycle he rented…basically the only safe transportation option after dark unless you have a car.
Soddo was 45 min+ walk into town. I could also walked 15 min down the frequently muddy road to get a bajaj (mini-taxi vehicle thing), which took me into Soddo. Along the side of the main roads, there were outside market stands selling fruit, 2nd hand clothes, cheap watches, etc. There were also the popular ping-pong & foosball tables throughout town that frequently had competitions in play...another surprise:) There were a few restaurants around town that we ate at. I enjoyed trying the Ethiopian dishes. Almost all of them were served with injera, a sourdough-like flat bread. The most common dishes were vegetable, potato, &/or chickpea ‘wat’ (stew)
& ‘tibs’ (cut up pieces of seasoned meat). The most common drinks were Ethiopian coffee (basically espresso served with salt), macchiato (coffee with spices & chocolate flakes:)), sprice (half tea/half coffee),
water, Ambo (sparkling mineral water), Coke/Fanta/Sprite, & fresh juices. As for shopping for necessities & food…there was the market for fresh produce, grains, beans, & clever things people made from recycled materials
; road side stands; & then the 3 ‘foringe’ stores around town with very basic ‘American’ things…some canned vegetables, cereal, cookies, candy, Raman noodles, basic cooking supplies, Red Bull, etc. More things were available in Addis. Prices in the market were wonderful…rolls $0.50, 1 dozen eggs $1, pineapple $0.38, papaya less than $1, 1 lb of red beans $0.25...I loved it:) There were other missionaries (from the States, Netherlands, & Norway) in Soddo working at the two orphanages & the Christian hospital. I really enjoyed getting to know all of them & hang out. I spent some time at one of the orphanages…the kids of course stole my heart pretty quickly. They loved to play & pose for the camera:)

On clinic mornings (Tuesday’s & Saturday’s), Mary picked me up in her ancient-but-still-running-great Land Cruiser at 6:30am…those were rough, early mornings:) Clinic was a 1.5 hour drive away (back northeast towards Addis). Part of the drive was on a main paved road, but then the last bit was on a rough dirt road out to the rural area. We passed traditional mud huts along the way mixed in with newer style rectangular mud houses. I was in a couple of these houses, & they were quite impressive! I never knew mud walls could be so sturdy! If they could afford paint for the walls, then you couldn’t really even tell they were mud. A number of these houses closer to town (= wealthier people) had electricity & nice wood furniture, & I even saw one with a TV. It’s just hard to put all those things together in my head. All along the drive to clinic (and even through town & just walking places), we would hear “foringe” yelled (aka foreigner!). Clinic was located in the small village of Godala (aka Ajora…named for “famous” twin waterfalls that were nearby). A line of people sitting on the ground were always waiting for us as we pulled up to the village’s community building.
The really sick people laid on mattresses or “stretchers” (made of wood & palm leaves) that were brought in by rural “ambulance” (aka donkey cart). A local pastor always prayed before we began our work. Dr. Mary then handed out little pieces of paper to determine who could buy medications from our pharmacy vs the more expensive pharmacies nearby…large-sized cards for those with a larger arm circumference (meaning they were better fed, hence healthier & wealthier & could afford the other pharmacies), small-sized cards for small arm circumferences. To give you an idea of a small arm circumference….most of the men were hard working farmers, & Dr. Mary could put her hand around their upper arm & her finger tips touched.
I thought it would be hard to see her distinguish between people like that, but truthfully, it’s pretty easy to see the difference. They’re all poor…no question about that…but some are so emaciated & are the poorest of the poor. I guess that helped me start to process the question of ‘How do you know who to help? Everyone’s poor.’ There are people that have all of their basic needs met, have clothes other than the one’s they’re wearing, have extras in their house like I talked about, but they’re still poor by our standards. Then there are those that don’t know where their next meal is coming from, are withering away & have no reserve for when they get sick, & really have no money or possessions. Then there’s the orphans, widows, & disabled…the people that really are helpless. Seeing all of this helped me begin to better understand scripture about taking care of the poor, orphans, & widows.
“Religion that God our Father accepts as pure & faultless is this: to look after orphans & widows in their distress…” ~James 1:27
But, then where do I fit into all of this? I think this experience helped me to know better where to focus my ministry efforts in Kenya & who to help when surrounded by poverty. But…what about all the extra I have despite being on a ‘poor missionary salary’? I still have more than the ‘well off’ poor in many places. God has blessed me, & I pray that He will show me how to steward those blessings well. I don’t know that there’s an answer to those questions…

There were 5-6 Ethiopians that worked with us on clinic days depending on the day of the week…translators, guard, & help with odds & ends stuff. There were 2 buckets that held lab supplies (urinalysis sticks, hemoglobin paper, etc) & equipment (otoscope, thermometer, etc). Dr. Mary started with the donkey cart patients, I started with the pregnant ladies & twins:)
Pregnant ladies started coming around 6-7 months (earlier if we were lucky) to get basic checks, an egg (for nutrition), & MinMeds (= multivitamin, iron & folic acid, & malaria preventatives…the latter because if they have malaria when they are delivering or up to 3 months after, they have an almost 100% chance of death!). The twin feeding program originated because mother’s generally don’t have enough food for themselves to be able to breastfeed 2 babies at the same time, so they would only feed the largest of the two:(
So…we gave the twin mom’s a large can of granola (which we made every couple weeks with oats, honey, peanut butter, protein powder, & oil + milk powder) every 2 weeks provided that both babies were gaining weight. They were pretty cute:) Once I was done with the pregnant ladies & twins, I started on the opposite end of the line that Dr. Mary was working on & we saw patients until we met in the middle.
I also did all the injections & helped with procedures (IVs, suture removal, dressing wounds, etc). Dr. Mary had me try to help with a tooth extraction on one of my first clinic days, but I was doing good to not throw up just watching!

Things I saw at clinic: post-partum sepsis, pregnancy-induced hypertension, leprosy, tuberculosis (lots of this, sadly)…abdominal, lung, arthritic, malaria (lots & lots of this), pneumonia, whooping cough, chicken pox, rheumatic fever, mumps, STDs, broken arm, worms (lots of this), ear infections, cataracts, eye infections, skin infections, amoebic dysentery, visceral leishmaniasis (this makes your spleen huge & is passed an insect bite), night blindness from Vitamin A deficiency, a platelet count of 2,000 in a lady pregnant with twins, goiter (lots due to diet deficiencies), Hodgkin’s lymphoma, probable miscarriages,…& the list goes on. Many of these we don’t see in the States because they’ve been eradicated, we have vaccines for things, & our nutrition is much better.

What else did I do on non-clinic days? I spent time helping Dr. Mary with the medical missions course she’s written (the one Angie, Elizabeth, & I took in North Carolina in April), as well as organizing medicines & packaging meds for pharmacy. Occassionally, Sophie will take over the care of a baby from the village whose mother died in childbirth & the father couldn’t take care of he/she in the early infant stage when they still need milk. When I arrived, 9-week old Asamino was living with Heather (the other nurse helping fill in for Sophie) & I. Another cute little guy:)
And right before I headed back to Kenya, we got a precious 5-week old girl whose mother had died from malaria 2 weeks earlier. Slowly, these baby’s are transitioned over to staying with an Ethiopian nanny before they return to the village around 6-months of age, when they are also eating all solid foods (since expensive formula isn’t an option in the village). I’m glad both Sophie & Angie had arrived at that point because we had our hands full!

I can’t help but think about Jeremiah 29:11 when I think about my experiences in Ethiopia…
“’For I know the plans I have for you’, declares the Lord, ‘plans to prosper you & not to harm you, plans to give you hope & a future.’”
As I said before, God set aside this time to teach me about a lot more than rural medical clinics, which is what I thought I was going for He knew I needed this time to prepare to be in Kenya…& now I’m so excited to be back! I have 2 albums of photos up on Facebook…enjoy! A picture’s worth a thousand words, right? :)

Ethiopia...you are beautiful... - Part 1
Ethiopia...you are beautiful... - Part 2