"If you want to walk fast, walk alone. If you want to walk far, walk together."
This African proverb really resonates with me as I begin this collaboration. As an American and an Emergency Medicine physician, I want things to happen quickly and efficiently. I find myself restless when things are slow. As I have spent this past week in casualty, God is teaching me patience. I am learning that if I am to be committed to this partnership and development of their department, I have to redefine my goals and expectations in preparation for a long journey.
After one week of working in Casualty, it is clear that it in order to make any changes, I am going to need the help of administration. Joe Mamlin (the founder and heart behind the IU program here) is going to introduce me to the director of the hospital and dean of the medical school this week. The Dean has a reputation of being a very nice man; I look forward to discussions about teaching medical students basic concepts in emergency medicine. The Director, on the other hand, has the reputation of being a very arrogant man with his own agenda. I am hopeful that I can match my agenda with his and win over some of his influence. We had a morbidity and mortality conference this past week - 20% of patients admitted to the wards die. The average length of stay for the male and female wards is 8 and 9 days respectively. The Minister of Health wants the hospital to decrease this to 7 days. I know that I can help make a difference in all of these numbers by instituting a few protocols in our Causalty Room. We have lots of patients with serious infections such as meningitis and sepsis who don't get antibiotics for many hours after being seen, bleeding patients with hemoglobins as low as 2.5 that don't get blood for hours (and they argue about giving fluids for volume as it will dilute their hemoglobin?), and the list of scenerios goes on. By helping him achieve some of his goals and provide better patient care, I am hopeful that he will help me out with staffing of the Casualty Room. I learned that the medical officers (my most experienced physicians having completed an intern year) are rotated to different areas of the hospital every 3-4 months despite their interest. I have been told by several that this is because the Director doesn't want anyone to get good at what they do, allowing him to keep them under his thumb. While I hope this isn't true, I pray that he will be open to allowing people to stay in Casualty for longer periods of time so that I might provide more effective teaching and emergency medicine training to the medical officers in that area. I remain optimistic that we will have a great meeting that will be the beginning of a relationship that will help facilitate the development of this program and provide better patient care.
After my week at work, I spent a great weekend here in town relaxing. Some friends (Marc, Erin, & Monica) and I had planned to make dinner on Saturday for Joe and Sarah Ellen Mamlin. What we had originally planned to be a small dinner turned into quite the party. Several "VIPs" arrived into town on Saturday morning. One is a two-time grammy award winning opera singer who is here for a few weeks to perform a concert and observe (she has asked to spend a half day with me in casualty - wondering if we can give all of our patient care in musical format - picture a mix between the shows Glee and House). Anyhow, since the Mamlins' are entertaining them, we ended up cooking dinner for everyone. Sarah Ellen really wanted us to roast some chickens for dinner. So, our preparation consisted of watching the Julia Child's episode on "How to Roast a Chicken" while we cooked. Many of you know how my chicken baking turned out in Zambia, so you can imagine that I was a bit nervous regarding this dinner now that we had quite the guest list. Everything turned out wonderful, making for a great night of food and company. So much fun!! Joe has asked us to make food for them every night...for him, I would consider it.
This African proverb really resonates with me as I begin this collaboration. As an American and an Emergency Medicine physician, I want things to happen quickly and efficiently. I find myself restless when things are slow. As I have spent this past week in casualty, God is teaching me patience. I am learning that if I am to be committed to this partnership and development of their department, I have to redefine my goals and expectations in preparation for a long journey.
After one week of working in Casualty, it is clear that it in order to make any changes, I am going to need the help of administration. Joe Mamlin (the founder and heart behind the IU program here) is going to introduce me to the director of the hospital and dean of the medical school this week. The Dean has a reputation of being a very nice man; I look forward to discussions about teaching medical students basic concepts in emergency medicine. The Director, on the other hand, has the reputation of being a very arrogant man with his own agenda. I am hopeful that I can match my agenda with his and win over some of his influence. We had a morbidity and mortality conference this past week - 20% of patients admitted to the wards die. The average length of stay for the male and female wards is 8 and 9 days respectively. The Minister of Health wants the hospital to decrease this to 7 days. I know that I can help make a difference in all of these numbers by instituting a few protocols in our Causalty Room. We have lots of patients with serious infections such as meningitis and sepsis who don't get antibiotics for many hours after being seen, bleeding patients with hemoglobins as low as 2.5 that don't get blood for hours (and they argue about giving fluids for volume as it will dilute their hemoglobin?), and the list of scenerios goes on. By helping him achieve some of his goals and provide better patient care, I am hopeful that he will help me out with staffing of the Casualty Room. I learned that the medical officers (my most experienced physicians having completed an intern year) are rotated to different areas of the hospital every 3-4 months despite their interest. I have been told by several that this is because the Director doesn't want anyone to get good at what they do, allowing him to keep them under his thumb. While I hope this isn't true, I pray that he will be open to allowing people to stay in Casualty for longer periods of time so that I might provide more effective teaching and emergency medicine training to the medical officers in that area. I remain optimistic that we will have a great meeting that will be the beginning of a relationship that will help facilitate the development of this program and provide better patient care.
After my week at work, I spent a great weekend here in town relaxing. Some friends (Marc, Erin, & Monica) and I had planned to make dinner on Saturday for Joe and Sarah Ellen Mamlin. What we had originally planned to be a small dinner turned into quite the party. Several "VIPs" arrived into town on Saturday morning. One is a two-time grammy award winning opera singer who is here for a few weeks to perform a concert and observe (she has asked to spend a half day with me in casualty - wondering if we can give all of our patient care in musical format - picture a mix between the shows Glee and House). Anyhow, since the Mamlins' are entertaining them, we ended up cooking dinner for everyone. Sarah Ellen really wanted us to roast some chickens for dinner. So, our preparation consisted of watching the Julia Child's episode on "How to Roast a Chicken" while we cooked. Many of you know how my chicken baking turned out in Zambia, so you can imagine that I was a bit nervous regarding this dinner now that we had quite the guest list. Everything turned out wonderful, making for a great night of food and company. So much fun!! Joe has asked us to make food for them every night...for him, I would consider it.
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| Success |
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I appreciate everyones' prayers and encouragement. I do have a special prayer request for the next week regarding political affairs occuring in Kenya right now. So, when I arrived to Eldoret, there was red carpet on the tarmac and a crowd of people around the fences of the airport. While I would love to believe I am that admired, I knew President Kibaki had just arrived as our plane was parked next to the Kenyan equivalent of Air Force One. He is making his way around the country to promote the proposed Kenyan Constitution that is to be voted on August 4th. Just as controversial as his presidency especially in the Rift Valley (where I am located), so is the constitution. The constitution is much like the American constitution and most educated Kenyan's and Americans are in favor of the document. However, the Kalenjin and Luo tribes (located in the Eldoret area) are not in favor, also not big fans of the president as they believe he won by electoral manipulation - hence the post-election violence in 2008. Given the tensions from the past, many are cautious about the upcoming vote on the Constitution, which is predicted to pass. So, please pray for a peaceful response to the voting on August 4th. I think the country is more prepared now than after the election. President Kibaki is sending an army of Kenyan military men to Eldoret in hopes of ensuring peace as the passage of the constitution will be his legacy. We will be prepared for possible evacuation but most (Kenyans and Americans) don't think it will be necessary. I think we will be staying in the IU compound for a few days following the vote to be cautious. At lunch on Sunday, Joe Mamlin was telling me they are meeting with the US Embassy this week to discuss our security in case a war breaks out. I'm not quite sure what my face looked like while he said this, but he smiled at me, put his hand on my shoulder and said "Don't worry, we'll protect you." So, no worries...and truly, I am completely at peace resting in the hand of an Almighty God.
I appreciate all of you walking with me on this journey. It is true that walking together allows me to walk much farther than I would by myself. Thank you!
I appreciate all of you walking with me on this journey. It is true that walking together allows me to walk much farther than I would by myself. Thank you!
"Walk in a manner worthy of the calling to which you have been called, with all humility and gentleness, with patience, bearing with one another in love." Eph 4:1-2
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