MZUNGU GIRL: Oh hey, concrete jungle…

Current Tunes: What Do I Know?, Ed Sheeran

MZUNGU. This is my favorite Swahili word of all time (sorta pronounced muh-zoong-oo). In Kenya I would often be called mzungu, usually in whispers from surrounding children but other times straight to my face as it is generally used for a person of European or foreign descent in Kenya (and in my experience, basically anyone with lighter skin). Kind of reminds me of the Spanish “gringo” of Kenyan culture. But I was told the word actually originates from the Swahili word zungu, which roughly translates to “spinning around from place to place” and adding the letter “m” at the beginning gives it ownership to a person who roams around aimlessly. So besides the fact that it’s just fun to pronounce out loud (I dare ya to give it a try, rolls off the tongue nicely) my wandering heart and nomadic lifestyle just resonate with the deeper meaning of this word. Even when I am physically sitting still, I often feel like my thoughts are spinning with my brain just sort silently whirring. I guess I truly am a mzungu to my very core.


And after four glorious family filled weeks in California, I’ve launched into assignment numero cinco…on Saturday I flew from California to Pennsylvania since my aunt graciously let me store my Jeep filled with my whole life in her shed while I was gone in Africa/California and from there I drove to New York. Homegirl is officially living in the BIG CITY! As in underground hot sticky subways, shoulder to shoulder shuffling, corner stand hot dog stands, and a wicked skyline that won’t quit city. To say I’m excited is an understatement but underneath that excitement lives a thin, healthy layer of anxiety and uncertainty. I keep picturing myself as a sweaty hot mess express that somehow managed to take the wrong line and end up late to work or as a lost puppy that has accidentally roamed into some questionable neighborhood that could be the setting of a Law and Order SVU episode. For someone that travels as much as I do, my sense of direction is pretty abysmal and if direction dyslexia was a thing, I’m sure I would have it. Which makes me all the more thankful to be reunited with my dear friend and old travel nurse partner, Kaitlin. We last traveled together a year ago with a six month stent on the West Coast’s version of the city in San Francisco. And on Thursday together we will start a new adventure at one of the premier cancer centers in the country in the oncology/surgical ICU of Memorial Sloan Kettering in Manhattan. It all just sort of feels surreal. Never in a million years did I imagine that I would live in New York, New York.  Well not before before I made one of the scariest and best decisions of my life when I took the leap and began travel nursing two years ago.

So what’s a girl to do in NYC in the summer? Ummm, I’m sort of hoping everything. Definitely a lot of walking. Today I used Uber twice and the subway yet still managed to rack up 15, 000 steps. While we might do a few touristy things, for the most part we plan to steer clear of tourist death traps like Times Square. I really want to see the city from a local’s eyes and seek out the hidden gems. Maybe I’ll rent a bike and go on a graffiti tour, devote a whole day on a quest for the best bagel in Brooklyn, or seek out the funky events I know NYC would have to offer like being a part of a crowd that breaks some sort of world record. I do know one activity that will be on my weekly to-do list… Eat. My. Face. Off.

If you are at all intrigued by food bloggers or Insta Food Porn, click here to check out @OneHungryJew. Just looking at her posts make my mouth water and heart skip a beat.

I also hope to catch a few outdoor concerts, eat some cracker jacks at some ballgames, and get lost in each of the boroughs. For my West Coasters, the Big Apple is broken down into five boroughs (basically five smaller cities) which include Manhattan, Brooklyn, Queens, The Bronx, and Staten Island. While my workplace is in Manhattan, Kaitlin and I landed an Airbnb Sublet in one of the up and coming neighborhoods of Brooklyn in the Williamsburg/Greenpoint area. I also learned my neighborhood is often home to many television sets like Girls, The Unbreakable Kimmy Schmidt, and Master of None. Hoping for a celeb sighting or two…Aziz, hollatyagirrrrl! And guys I am just gaga over this loft duplex apartment.

The building itself used to be an old factory that was recently renovated into furnished short term rental apartments. The real exposed brick, dreamy embroidered rug, and loft ladder to the second bed got me looking like the heart eyes emoji. Plus the AC is included in the rent which is a BFD since y’all know I sweat buckets and this East Coast summer humidity is going to come at me with no mercy.

Can’t believe this time last year I was gearing up to move to Boston. Good gravy, sometimes I am just so overwhelmed with God’s countless blessings and the opportunities I have been given to see and meet His people in all forms, across so many different locations. Speaking of which, if anyone has any church recommendations in this city, drop me a line please. 

Hope everyone is prepping for some fun summer vacay plans! Just got home from a Mets game at Citi Field in Queens and I could definitely get used to this city life :]

Cheers and keep on wishing!

Miriam

Crafted For Kindness

Current tunes: Fickle Heart, Ira Wolf

She came rushing and panting, a bundle of squirming blankets in her arms. She laid him down, the tremors starting to subside, but his eyes still deviated far right and my chest felt tight with panic as I surveyed the look on Michelle’s face. His little belly was puffing in and out and you could hear his crackled, labored breathing. Weary, ill adults I could handle, but a seizing baby in respiratory distress? I was out of my element, but Michelle, a former ER nurse turned FNP and the founder of this clinic, started to delegate tasks and as a team we surrounded the toddler and got to work. While two other clinical officers worked to get an IV line in one of the oh so tiny thrashing limbs, I grabbed some vitals- heart rate in the 150s, respiratory rate of 55, SpO2 87-88%, febrile 38.9C and when I put my stethoscope to his little chest I heard wheezes and rattling. Michelle rushed to get a breathing treatment started. We don’t have oxygen tanks at the clinic but we do have a nebulizer machine. The mother sat silently in worry, her brow furrowed as she watched us swarm her child. I supported his neck up with one hand and held the treatment in place, his screams actually aiding him in getting the medicine more quickly. And eventually his breathing slowed and his oxygen levels began to improve. My hand was cramping, holding the treatment in place and trying to avoid the bundle of cloth that covered his lower half as I could smell and see was soiled, but I could finally sigh in relief as they managed to get some IV access and start antibiotics and fluids. His tests came back positive for malaria, typhoid, and it was obvious he had some sort of respiratory infection as well. And the seizure was likely a result of a sustained high fever caused by his three infections. I handed him over to his mama now that he was stable.

I went back to Michelle’s office to reflect on what I had just witnessed…I couldn’t help but think of the outcome if he had not made it to the clinic. Malaria is a common and treatable disease but the mortality rate for young children is actually quite high. And while it’s not everyday that the clinic has real emergencies, it does happen. I felt the weight of everything and as we drove home that day I looked over at Michelle and just said, “Michelle, you and your clinic, you saved a life today.” And while it’s an immense amount of work to run an NGO in a third world country, I know it’s days like today that reaffirm her efforts are not in vain.

I share this story not to flaunt our volunteer efforts or for praise. They knew what they’re doing and while it was an honor to assist, the clinicians here are skilled and they could have functioned fine without me. In fact, I was the one learning since caring for babies is not really in my scope. But it feels amazing to have purpose and be needed, doesn’t it? Usually when I share about the volunteer opportunities I have had, most people show interest in doing something similar. However, one time I shared with a co-worker about my first Africa trip in 2015 and her response was,  “Oh that’s cool. I want to do that too. But not with a church. Because I don’t believe in doing good things to get to heaven, I’d rather do it because it’s the right thing to do.”  I stared at her, taken aback, not sure how to respond. I think my silence made her realize I found it a little offensive as she just indirectly said that my efforts were for personal gain only or maybe only done out of fear of a higher power (that she probably didn’t think existed for that matter). I was actually more sad than offended. Sad that this person believed a walk of faith and service to others was solely to get spiritual brownie points, as if God keeps tabs on my good deeds and is unconcerned with the state of my heart. Salvation doesn’t work like that. If it did we’d all be screwed. 

So it got me thinking, is there such thing as a selfless good deed? Another friend of mine challenged me with this question before. He insisted it doesn’t exist and that we are always out for ourselves making us look or feel good, even if it is done subconsciously.  Of course I ended up a little defensive, trying to disprove his points but after this second trip to Kenya I think I’ve come to a new perspective  about selfless deeds. What if they don’t exist? And what if selfless deeds don’t exist on purpose?

As humans, I believe we are created differently. We have a soul. A spirit that allows us to think, feel, love, create and separates us from all other walks of life. So what if our souls were intentionally designed to hunger for serving others and the joy that comes with it? Maybe it feels good to do good for a reason. Maybe we were crafted for kindness and are called to live for more than ourselves. And I like to hope that just maybe this helps to spur humanity to pay it forward. Think of the last time you put some one’s needs before your own…okay, so it probably doesn’t always feel good in the moment, but when you feed your soul in this way, I think you build character. So you’re still gaining. And other times it does feel a little magical knowing you made a difference for just one person. Because whether you’re a theist, atheist, agnostic, or are undecided on who you serve or your purpose on earth, I think we can all agree that our world could use a little more “selfless deeds.”

Which is part of the reason I re-entered America feeling so refreshed. Like I actually believe that I needed this opportunity and time away more than that African village needed me. It was so cleansing to be unplugged and away from the distractions of my first world probs. It was as if time had stopped with little need to check my watch or phone (the village has spotty connection let alone reliable electricity…our power would go out daily). My schedule was simple, pre-arranged, and filled with many opportunities to bless others and meet people who’s stories really put my own into perspective. After a day of working at the clinic I would go catch up on some much needed Zzzz’s, stroll down by the river, actually read books without picking up my phone every few pages, and sometimes wound up asleep by 9:30pm…woah, who is this girl? Now I think over a long period of time I probably would get antsy because I tend to be a busy bee and struggle with being physically and mentally still but for those three weeks, I just felt free. Also, getting to live with Michelle and William Kiprop, the missionary family and founders of the clinic, and watching firsthand what it looks like to live so sacrificially was such a blessing to me. They definitely have changed my perspective on what it looks like to live for others and Jesus. They do more than provide healthcare to an underserved population. People would often randomly show up on their doorstep at all hours of the day and night asking for food, money, health treatment, a ride, etc and while the clinic and building a hospital in the area is their tangible mission, overall they have committed themselves to representing Christ by providing hope to a community that may feel less than or forgotten. And it was an honor and privilege to watch and take part in and I know this just the beginning of many years/trips to come of working with the Kiprops and Hope Matters International in Kenya.

Oh and just a quick PSA- you don’t have to leave your home or work in the medical field to feed your soul in this way. If there’s one thing I have found through traveling is that people are broken all over the world and struggle with the same sins, hurts, and tragedies. I truly believe that becoming more mindful of helping others and intentionally serving in your everyday life can bring you so much joy and purpose and I’m sure there are needs in your community, heck even in your immediate family, that you can impact. You just have to start looking. Because people matter. And people need people. People need you.

As far as my current whereabouts, I am back in California for a month, spending time with family and was able to swing a temporary registry contract back at my home hospital in Fresno. Not going to lie, it feels pretty darn good to be back with my Trauma ICU family and in a familiar workplace. So if you have seen my Snaps or are wondering if I stopped wandering since I’ve been in the 559 for longer than normal the answer is… nope, nope, nope. But is nice to be back on the West Coast (best coast). I counted and in the last 11 months I think was only in Central Cal for 12 days…weeeeird. But I’m going to soak up the Cali sunshine as much as I can before heading back East. I think I am currently the whitest I have been since leaving utero. Vitamin D stat please.

Cheers and keep on wishin’!
Miriam

KENYA (week 3): I am Jepkoech

Ni naitwa Miriam Jepkoech. Nina toka California. Mimi ni muuguzi.
I am called Miriam Jepkoech. I am from California. I am a nurse.

The Kenyan wedding I crashed

Current tunes: Some African radio jams and the windshield wipers battling the rain
Current Location: En route to Kipkaren from Lake Nakuru National Park

Equator Quick Pic

My broken Swahili may not be much, but I enjoy watching the kiddos giggle at my Swahi-nglish (Swahili English) and noticed it does help establish rapport with the older clients at the clinic. Interestingly enough, Swahili is derived from Arabic and I’m finding there are many words that are the same or very similar to my father’s native tongue. Shout out to my Theta, aka my immigrant Syrian grandmother, that lived with my family during my childhood…your loving shouting matches at me to clean the tornado that I called my bedroom, to help with dinner, and to change out of my inappropriate outfits by Syrian standards, have all aided me in my Swahili efforts. I also found a deck of Swahili flashcards in the Kiprops’ home and have been trying to write all that I’ve learned phonetically in what I call my Swahili Bible. And who knew Disney’s The Lion King actually has real Swahili words embedded into the film? The leading cat Simba does mean “lion,” the baboon named Rafiki means “friend,” and the classic Hakuna Matata jingle really translates to “no worries” just as the lyrics state. Between Mickey Mouse and my Theta, I should be fluent in no time…yeah, right.

Oh and I should probably address this “I am Jepkoech” (jep-koh-etch) business. Kenyans are all born with a middle name determined by the time of day/the events surrounding their birth. Because I was born in the morning, William has given me my Kenyan name of Jepkoech. But there are names relating to all sorts of events, like Jerop would be for a baby girl born while it was raining and Jepchumba literally means a baby girl born “with white people around.” In addition, there is a masculine and feminine prefix change, so if I was a boy I would be Miriam Kipkoech…and to complicate things further these names are part of the Kalenjin tribe, which is just one of 43 tribes in Kenya. Don’t even get me started on how they determine your last name. Something about females getting the father’s surname (which will later change post marriage) and males inheriting the father’s middle name as their last name…I think??? While it gets confusing, Michelle says to just be aware that families do not all have a unified last name and it is common for people to give their first and middle name only, if asked.

But other than this crazy Kenyan name game, I do feel that because I am staying here twice as long as I did in 2015 and have come solo this time around, I have been able to immerse myself in Kenyan culture in a deeper way. Living with the Kiprops (yes, William Kiprop was a rain baby) has been such a blessing. If you ever have an opportunity to live with locals while traveling, do it! It always provides for a richer experience and better understanding of a country’s people.  And through working along side them at clinic and getting to know some of the patient’s families, I really am loving the hearts of these Kenyan people. William’s family is from this area, Kipkaren Village, and is part of the Kalenjin tribe that I mentioned before. Of the 43 tribes, it is the third largest. Kalenjins are known for their farming abilities and running talents. The Kenyan Olympic distance running team is often comprised of Kalenjin runners and the largest urban city in this area, Eldoret, is sometimes called the Home of Champions because of the athletic abilities of its natives. Sadly, I have only gone on one run in the last few weeks of living the village life and while the scenery is beautiful, the rocky unpaved dirt roads, the dogs and random livestock that roam the streets, and the fear of getting lost without cell service has deterred me from getting in my usual mileage.

William, my #1 local and Swahili tutor

When I asked William to describe the parts of Kenyan culture that he feels are the most valued, he first starts by emphasizing how each tribe is unique and has their own traditions and language separate from Swahili. But something they all value is respect. This is easily seen in the way they greet each other, usually ensuring they shake hands with the every person in the room and often using two hands to do so. Michelle also explained that it is a very formal culture with celebrations often having special ceremonious traditions and speeches galore. Which I found interesting since most locals have been pretty quiet around me. I asked William if this was because of the language barrier and while he says that might be a part of their silence, he adds that in general Kenyans tend to be more reserved. As an American turned ten year resident of Kenya, Michelle gave some insight on what she feels is one of the most notable aspects of Kenyan culture. For Kenyans, the individual mindset is put on the shelf to make room for the needs of the entire community. In general, the extended family is above the nuclear family and the collective experience is always considered when making important decisions.

It is also more of a paternal society with men holding more leadership positions than women and the education gap between the genders is very prominent. In the village, it is rare to see women wearing anything other than a skirt or dress and Michelle even estimates that of all the automobile and motor bike drivers, roughly 5% are women. And it’s true, other than Michelle I have not seen one female driver on the road. Which is probably why I was getting intense stares piercing the windshield when I had to drive their Toyota 4Runner home from the clinic last week. I could just feel their eyes…“Look out! Who is this Mzungu (foreigner) girl that has stolen the Kiprops’ car?”  Or maybe they heard my heart booming in my chest as I nervously learned what it feels like to be on the left side of the road while sitting in the right sided driver’s seat for the first time. Not going to lie, even though it was a quick ten minute drive on mostly village roads, my scrubs had a thin layer of sweat soaked in when I finally parked in their driveway. And while it is very unlikely to happen on a short village drive, I later learned that people are easily thrown in the clink if caught driving without a Kenyan license…yikes bikes.

Lived through my first Kenyan driving experience

One of the biggest things I noticed is the lack of urgency when keeping a schedule. Again, this is partly related to respect as putting your next meeting on hold shows that you are committed to being present with your current company. But I also think Kenyans are just a people that are comfortable with having a relaxed view towards punctuality. Just last week I third-wheeled it with the Kiprops and crashed a Kenyan wedding. The invitation indicated a start time of ten o’clock in the morning. So when I asked William what time we should leave knowing that we lived a good hour or so away from the venue, he nonchalantly replied that 10ish would be good time to leave the house…WHAT? In America they would shame you for that. And what do you know, we pull up to the wedding around 11:30am and the bridal party is not even all present yet. #HakunaMatataLife, am I right?

Well, I’m currently on the road back home (or what has been home for the last three weeks and it really does feel that way now) from Lake Nakuru National Park. I was lucky enough to have a quick one night weekend getaway with my Kenyan familia yangu (my family) to a self drive safari park. Not lion, I literally got wild this weekend…lame dad joke FTW.

And while I was so fortunate to safari in the famous Masai Mara during my last trip to Kenya, getting up close and personal with these amazing creatures does not get old (click here to check them pics and see why you need to add an African safari to your bucket list).  Only a few days left before I say kwa hari (goodbye) to my Africa life. And I honestly don’t think I’m ready…

Cheers and keep on wishin’!
Miriam

KENYA: Catch me at the clinic

Current tunes: Tourment d’ amour, La Fine Equipe & Saneyes
Current location: Kipkaren Village, Eldoret, Kenya

***This post is more laden with health care references and might be a bit uninteresting to my non-medical peeps. But I hope you give it a go anyway :] Also, permission was granted by each client before using their photo.

In my four short years of inpatient care at large facilities I have come to find that American hospitals are more so large businesses with ill clientele rather than places of healing and refuge for the sick. Perhaps this is part of the reason why it has been an interesting transition from working in a large facility of Western medicine with patient surveys and resources galore and  to a rural village clinic. I know this is sort of like comparing apples to oranges but the hypochondriac patients are nowhere to be found, there appears to be no sense of entitlement, and I can tell many are just grateful to have access to affordable care near their home.

 

Front of the clinic

And I really just have to tell myself to turn my ICU brain off and have come to find that the motto here is “give the best care you can with what you have.” On my first day I remember finding it a bit unnerving to place an intravenous line (aka an IV) without gloves and using needles that don’t have safety mechanisms on them to protect the clinician…but when resources are limited, again I go back to the motto. Of course, this does not imply that they give insufficient care here. In fact, not being able to magically get a 12 lead EKG or get a detailed health history forces the staff here to be more in tune with relying on their clinical skills of observation. Also, the clinic recently had a visit from the Kenyan Ministry of Health and were given a pretty stellar review.! Michelle has even worked to implement an electronic form of charting, known to many in America as an Electronic Medical Record (EMR). This is probably the only rural village clinic in the country that has converted to an electronic system, so it’s been pretty exciting for the staff and Michelle to grow this ministry in a way that will help provide more efficient and organized care.

While Hope Matters International offers more than medical support to the community, their Village of Hope Medical Centre focuses mainly on providing the community with walk-in urgent care treatment, maternal child health/prenatal care, diabetic counseling, and will soon be offering dental services! The clinic also has an onsite diagnostic laboratory that provides testing for the most common ailments in this patient population. The day to day patient demographic is most often composed of people with malaria, typhoid, gastric ulcers/infections, and those needing chronic wound management. I explained to one of the clinicians that I had never treated malaria before and hoped to learn more about the course of treatment and the disease process. She stared at me for a second in disbelief and said, “Never? You’ve never seen a malaria case?” I wasn’t sure if I should feel blessed or ashamed…and not to get all Miss-Frizzle-Magic-School-Bus on you, but let me give you the quick and dirty low down.

Malaria is a common problem in Kenya, especially here in the highlands

Basically malaria starts with a parasite carried by mosquitos causing persistent fevers, gastrointestinal disturbance like vomiting/diarrhea (which then causes dehydration), and terrible body aches and pains. Most everyone in Kenya gets it at least once (and often several times) in their lifetime.  Due to it’s prevalence, it is highly recommended to take anti-malaria pills for visitors and for the general public to utilize mosquito sleeping nets.  Call me a princess but I actually have grown to love my net and I pretend it’s the canopy bed my parents never purchased for me. Unfortunately if the disease progresses to a severe stage, patients suffer from convulsions/seizures from the persistent fevers, have respiratory distress, low blood pressure, anemia, severe dehydration from the inability to eat/drink, and loss of consciousness (among other things). I haven’t been here long but every day there seems to be children presenting with rampant, gnarly fevers as high as 103-104 degrees and are crazy dehydrated. So by the time they get to us we often need to give intravenous fluids and antibiotics. The cure is in fact antibiotics but I’ll spare you and not nerd out over the pharmacologic treatment here. PS I know I didn’t properly cite each piece but click here for the published guidelines from the Kenyan Ministry of Health!

However, I will say that in general, giving medicines via intramuscular injections (for my non-medical folk think any vaccination/shot you’ve been given) seems to be the gold standard for non-emergent cases as time, space, and resources do not always allow us to admit every patient for a course of IV drugs and antibiotics. And I know back home we generally go for shots in the arm but because the glutes are a larger muscle group and much of the community is malnourished, we just go straight for the buttocks (I have never given more booty injections in my life until I volunteered in Africa). In fact, before I even attempt to sloppily mime/use broken Swahili to explain the treatment plan, most patients are already pulling down their trousers to expose the top of one cheek, knowing that gluteal injections are just the norm when receiving treatment. After an initial intramuscular injection of a drug that is needed more quickly than it would take to swallow and absorb, it is then we would send them home with oral medicine.

chronic leg wound

Twice a week we have scheduled dressing changes for specific chronic wound patients. This past Friday I had the pleasure of tending to three of our wound clients and was astounded to hear the length of time they have been afflicted with caring for their injury…from three months to over two years! Can you imagine having an infected cut for two and a half years?! Because the cleanliness of an environment and nutrition play a large role in wound healing, these acute injuries often turn chronic.  When you have a large open area of skin and go home to a mud hut with dirt floors, probably can’t afford to take time off from work to let it heal, and then do not have a protein and nutrient rich diet always available to aid your body in the healing process, well it all just makes for a complicated situation. It pained me to tend to a chronic leg wound of a child as I couldn’t help but think that back home as an inpatient we probably would have pre-medicated the child with IV pain meds and numbed the site with a numbing agent to try and combat the imminent pain before taking down the dressing. But again, here we do what we can with what we have so I tenderly redressed his wound, repeating pole, which is Swahili for “sorry,” over and over as the child grit their teeth and released a few silent tears.  This made me think about my initial desire to enter the realm of pediatric medicine but after struggling to get an IV in dehydrated screaming three year old…well, maybe I’ll stick with my adult homies for now.

I can’t believe I’ve just hit the halfway point of my trip. This past weekend I crashed a Kenyan wedding with my host family but I’ll get into the details of that later this week. Oh and I befriended this little guy, too.

Cheers and keep on wishin’!

Miriam

PS Interested in furthering HMI’s ministry and goal in providing this area with holistic care? Click here :] Want to check out all my previous posts on Kenya? Click here.

 

KENYA: Frogs, flying roaches, & termites, oh my!

Current Tunes: None…unless you count the sweet sound of winged termites pounding against my windows.

First things first- shout out to my boy Benadryl! It took about six days but I think I finally got rid of my jet-lag.

Michelle

Now let’s catch y’all up to speed. Last Thursday I flew into Eldoret via a small commuter plane and was greeted by Michelle and William Kiprop, the missionaries I am interning with and the founders of the NGO, Hope Matters International. This couple continues to amaze me and I am so grateful to be an honorary Kiprop family member for the next few weeks. Our first stop was a hotel cafe, as the wifi can be spotty in the village and Michelle needed to catch up on some serious admin work.  It’s been two years since I last volunteered with HMI or have seen Michelle so it was here that she and I played a little catch up. I expressed to her how grateful I was that they welcomed me on such short notice (did I mention I solidified my decision to come end of February?!) and I admit that I think I needed Africa more than it needed me. I could not wait to have a to-do list that involved nothing about deciding future plans or moving.  Overall my soul is just eager to practice intentional serving and could probably use a little reboot by disconnecting from own self-revolving bubble and reconnect to purposefully pursuing the simplicity of His calling- to love God and to love others. Alright, tangent complete and back to Kenya.

Our second stop at the local Nakumatt, basically a Kenyan Super Walmart, was a good reminder that I had definitely left American soil. I had forgotten that it’s entirely normal to have soldiers with rifles and metal detectors stationed at the entrance of major shopping areas in Kenya. Unfortunately, this country has a history of terrorist attacks at these types of locations and I was redirected to have my bag checked and be screened after I mistakenly tried to enter through the exit door. In addition, certain grocery staples are limited here and Michelle griped that they have yet to stock fresh butter for several weeks now.  I gasped as I saw a jar of peanut butter priced at 1,350 Kenyan shillings (roughly $13.50 USD) but also did a little happy dance knowing my Trader Joe’s jar had made it safely through customs (my PB addiction has made nut butter an important part of Miriam Bourdain’s travel essentials…) And if these weren’t reminders enough that I had hit foreign territory, the traffic here will shake anyone up. Rules are mere suggestions as cars, matatus (large public transport vans), and packed piki pikis (motorbikes) zip in and out of traffic all while pedestrians walk through the madness without fear. But the crowds grew less dense and the streets became more bumpy as we left downtown Eldoret and began passing through the local suburbs outside the city until we finally reached Kipkarren Village. Kipkarren is not only William’s hometown but the main community that Hope Matters serves.

Little Ryan and I on Easter Sunday

As we pulled up to the Kiprop home, Ryan, Michelle and William’s adorable five year old son, was running around the front yard with their four dogs. I noticed some new additions as three half built buildings surrounded by laborers stood to the right of their home and I learned these would soon be housing for a new wave of volunteer groups for the organization. Just below the construction would be my home for the next three weeks. I’ve already grown to love this little cottage and it is actually larger than most of my apartments I’ve had while travel nursing.

Michelle warned me that as rain season approaches it is not uncommon for the electricity and water to go out…and of course as unloaded my bags we found this to be the case. Welcome to rural Africa! Since my arrival, the electric power seems to disappear intermittently, leaving and coming back as it pleases. Fortunately the house is equipped with a bucket of water for washing and pre-charged lights and flashlight and after years of tent camping with my dad, this doesn’t phase me. The critters on the other hand have been throwing me for a loop. I’ve already encountered flying cockroaches several inches long, giant moths flying into my mosquito net, a frog in my toothbrush cup, hoards of winged termites brought on by the rain, and the geckos in my bedroom are now my new household pets. My morning wake up call is often a rooster, cow, or the neighboring kid (that goat sure has a way with words ;]). But I can manage these as long as the malaria infested mosquitos stay away! Which reminds me, time to go pop one of my anti-malarial pills.

The next few days were spent in the clinic just down the muddy dirt road from the Kiprops’ (think Disneyland’s Indiana Jones ride x 5) and I threw myself into learning the flow of the clinic, becoming familiar with the foreign supplies available, and getting acquainted with the staff.  It feels good to work without feeling like I’m at work…does that even make sense? I guess what I mean to say is it feels good to put on those scrubs, to work long hours, yet not feel drained. And just feel appreciated. But I am still weirded out that I am often called daktari, or doctor in Swahili. I’ve even corrected them insisting I’m a muuguzi, or nurse, but when you’re an American in scrubs that is generally the first assumption.  Although, I’d be lying if this experience hasn’t been causing my original plans to be a Nurse Practitioner to resurface. I tucked those dreams away two years ago when the thought of going back to school mixed with the lust for adventure through travel nursing overtook me.  Plus I questioned if I would excel in a higher role of authority and if I desired a position with more liability. But working with the clinical officers, the Kenyan equivalents to a Physician’s Assistant, at the clinic and watching Michelle, a Family Nurse Practitioner, work with these suffering people has got me thinking about what that could look like for me.  Over these last few days I have been so intrigued by the diagnosing process and am revisiting articles/books to review certain disease processes and it’s actually been, dare I say it…FUN. Watch out, nerd alert. Let me remind you, I mostly excelled at three things growing up: finishing up my (second) dinner without parental request, growing eyebrows, and school. So maybe it’s time to revisit this NP plan. Or least make a final decision about graduate school in general.

 But that can wait, because right now I’m going to keep enjoying the simple routine schedule, the weirdly calming torrential downpours, the books I’m actually plowing through for a change, and the cleansing restriction of spotty wifi. The clinic is where I sometimes can post a Snap I’ve previously saved to my story or an Insta if the hotspot pulls through for a second…in fact I’m hoping this post makes it up!

Cheers and keep on wishin’,

Miriam

 

DEUCES DUKE: Carmen Sandiego is unemployed…

Current tunes: Africa, Toto
Current Location: Nairobi, Kenya

Is it weird that I sort of like in flight turbulence? Sure, it can be unnerving, but every little bump is a good reminder of the fragility of life, how lucky I am to be alive, and ultimately it means I’ve got something good. That I am fortunate enough to feel like I have something to lose and people that care for me. Ha, you’re probably thinking, “Wow, you really feel all that from a little jostling in an airborne tube shaped can of sardines?” Well, I have a lot of feelings. Sue me. But really, it just reminds me that if my days are numbered, then I better be putting them to good use. And for me I think it means being a good steward of time, talents, and blessings by exploring cultures and and caring for/getting to know people. Over the last two years I have lived in four different cities and have had the pleasure of crossing paths with all walks of life. Just thinking about comparing the chill vibes of San Diego, the culturally diverse and progressive ways of San Francisco, and the amazing history and tough East Coast attitude of New England makes me feel like I’ve switched countries rather than cities with each move.  And most recently my heart has been overwhelmed by the sweetness of my new Carolina family. While I only spent three short months working at Duke University Hospital in North Carolina, I was scooped up into the arms of a small group of young professionals from a church I connected with at the beginning of my move.

While I enjoyed eating my body weight in flaky biscuits, made wonderful friendships, and had time for a lot of self reflection in the quietness of the South, for some reason I didn’t feel the yearning to extend for another few months like I usually do…which leaves me where?

UNEMPLOYED, Y’ALL.

For the first time since I started traveling, I finished a contract without having my next job signed and ready. Nope. Instead I decided to take six weeks off to go home for a bit and also hightail it to…AFRICA. In fact I am starting this post in the Amsterdam Airport on a two hour layover (give me all the stroopwafles now please).

So why Africa? Well If you look back at some of my posts from a few years ago (click here!) you’ll find that Africa found me in the summer of 2015 right before I started travel nursing. I guess I’ve been so consumed with planning my next steps that I’ve forgotten how to just enjoy the moment. Don’t get me wrong, I have been having blast hopping around and eating my face off. In the last three weeks I was a crazy woman and  somehow squeezed in biking along the pastel mansions of Charleston, SC, ghost touring in Savannah, GA, beer sampling in Asheville, NC, pretending to enjoy spring time snow in Boston, MA, and visiting with some cousins in Pittsburgh, PA…Houston, I already know I have a problem and I’m definitely not complaining. I just think I’ve spread myself a little thin. (PS a belated post on my Southern road trip and all the tasty treats that were had is coming your way soon.)

Charleston, SC

And in all honesty I left Boston feeling pretty internally weary, a little disconnected from my roots, and out of touch with the person I want to be. The person I know He created me to be. So I internally knew what my next MOVE should be. And that’s to not. To sit. To be still. And let God work.

While this technically doesn’t support me being physically still, for the next three and half weeks I’ll be living in Kenya and partnering with a small medical ministry called Hope Matters International. I will be living with the founders, Michelle and William Kiprop. Michelle is a Nurse Practitioner from California and moved to Kenya in 2007 with a heart for the African people she had met while serving abroad during school. She later married William, a local Kenyan, and together they have fostered an organization that strives to provide holistic care for the physical, emotional, and spiritual needs of those living in their Kenyan community. While their main platform is health care and education, they also have out reach programs supporting agricultural education and care for orphans. If you’re interested in learning more about their work in more detail or would like to help fund our cause, please click here.

While I only have a few weeks there, I’ll be working at Village of Hope Medical Centre in Kipkaren Village of Eldoret City. The clinic is often packed and sometimes short staffed as Hope Matters runs off of donations. Village of Hope treats basic illnesses/injuries and offers diagnostic, laboratory, treatment, short-stay admissions, and pharmaceutical services and is the only access to health care for many of people in this community. I will also help start laying the foundation for and doing community research to get the ball rolling on the hospital, YES HOSPITAL, that Michelle and William have been striving to build in this area. There is definitely a huge need and I am thrilled to be a part of this process even if it will be quite some time before this dream will come to fruition…crap boarding to Nairobi. BRB my people…

(8 hour flight and several thousand miles later…)

Guys, I just sat next to a nurse on my 8 hour flight that was born and raised in Kenya but now works in Seattle!  She even gave me a little Swahili lesson, specifically going over medical phrases, and wrote them all down for me so that I could be more effective in the clinic. I also made friends with a Canadian paramedic that was sitting across from me. He is coming to Kenya for what he calls a “volucation” (volunteer vacation…yea totally stealing that and coining it in the Miriam Webster Dictionary) as well. Coincidences? God is good, people.

Anyways, that’s all for now. When I get back to California I’m just going to have faith that a door for the right job at the right place will be open and waiting for me. Prayers, good vibes, and thumbs up emojis are all appreciated. Thanks for tuning in and follow my Africa updates here on TDD. Well that is if I have decent wifi…I have internet access right now in this guest house in Nairobi but starting tomorrow I’ll be in a much more rural village so it may be every few days that I even get some subpar access but am kind of looking forward to being unplugged for a while. Raise your hand if you your smartphone usage is starting to disgust you and makes you want to ralph when you realize how long your hand has been in the cramped iPhone grip hold. Guilty as charged.

Okay, after 26 hours of traveling, homegirl needs to sleep since I have one last commuter flight tomorrow from Nairobi to Eldoret. Can’t wait to cuddle up with my mosquito net. 

Cheers and keep on wishin’!

Miriam

DURHAM&DUKE: An update from a faux southern belle

Current tunes: You Broke Up With Me, Walker Hayes

fullsizerender-20So the other day some one at work asked me if I was American…wait, what? I just kind of laughed and I don’t really think they meant to be offensive. In fact, I know that. When I said I was from California, he responded, “Well, I mean, what are you?”
Hmmmm, translation → “We haven’t seen the likes of you ‘round these parts…

img_0889Happy Valentine’s Day readers! The only thing Valentinesy about this post will be my heart shaped sunnies that make me look my shoe size instead of my age. Oh and mentioning that my father lovingly told me yesterday that this is the last year he will stand in as my valentine… ha love you too, pops. I have officially been in North Carolina for one month and have finally got the gist of how things run in my new temporary work place, Duke University Hospital, in the Trauma/Surgical Intensive Care Unit. I’ll be honest, I was a little nervous to be employed in such a reputable facility and Duke required me to take/pass more competency exams than any other hospital before officially granting me the position…what if I didn’t measure up?

But I also just celebrated my four year nursiversary (It’s a real word in the Miriam Webster Dictionary, I swear, check out last year’s nursiversary post here), and it turns out, somewhere along the way, I actually kind of like know stuff now…”kind of like know stuff now?” Okay that sounded incredibly lame and basic ha. I guess what I mean to say, is while there is always something new to learn, I finally feel like I have acquired valuable nursing knowledge and can approach each new assignment with a little more confidence than the last.  And I’m happy to report that yes, Duke is a pretty stellar place to work with resources galore. I mean this unit is the same number of beds as my old staff job but is close to twice the size!


As far as my new digs, I’m chilling in my own basement apartment in a home that I rent from this really generous and kind older couple. And for the first time ever I have zero roommates! Going from four roomies (three of which were male) to my own space has been fan-freaking-tastic. No more questionable short hairs all over the bathroom floor, no more hiding wine from the sneaky closet drinker, and no more feeling like a maid in my own home. Not to say I disliked them, but I can see why girls only tend to live with dudes they are in love with…And for the first time since I left Fresno, I’ve returned to that suburban life. I haven’t used public transport or ridden in an Uber in over a month and I can buy whatever I want from the grocery store without worrying if it will be too heavy to carry home! Hellllllo watermelon!

But I’d be lying if I said I didn’t miss Boston and all my friends there. Making my own community here in Durham is taking a little longer than it did in the bigger, more populated cities I have lived in while travel nursing. Luckily, I plugged into a church pretty early on and that’s been an incredible blessing since most of the people I hang out with are from the small group I joined. But overall I still spend most of my time solo, exploring the Durham/Raleigh/Chapel Hill areas, coffee shop journaling, and reflecting on and praying over the path ahead of me.

Cocoa Cinnamon: My favorite java house hangout in Durham.

Cocoa Cinnamon: My favorite java house hangout in Durham.

My manager already asked me if I was open to extending another three months in addition to the three I currently am contracted for. Honestly I don’t know where I’ll be this weekend let alone two months from now. And my current apartment isn’t even available for the whole time I’m contracted here…which reminds me I should start looking so I’m not homeless in a couple weeks. Oh the life of a travel nurse.

While I have only been in Durham for four weeks, here are a few things I’ve discovered about the Research Triangle Park area:

  • The Southern stereotype of being generous and friendly is definitely real. Maybe coming from Boston potentiates it for me even more but I appreciate living in a place where chivalry is not dead.
  • But, the stereotype of life moving slower here is real, too. I always prided myself in not being a person that succumbs to road rage. But these cute, southern grandmas driving below the speed limit are really starting to overcook my grits.
  • The color blue you wear really does matter. Research Triangle Park represents three major universities and they all are in close proximity to each other- North Carolina State, Duke University, and UNC Chapel Hill. The Duke-UNC Chapel Hill basketball rivalry has been argued to be one of the greatest college sports rivalries of all time. The tickets to a rivals game between the two can be over $1000 and I was told the student section tickets are given away by lottery. I was able to find affordable tickets to a Tuesday Night UNC game against a lesser known team and the place was still pretty packed. Where do I fit in all this? I might regret saying this but while I should be a Blue Devil since I am employed at Duke, I’ve been making more friends with Tar Heels and am leaning on sporting that Carolina blue.
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  • Pimento cheese is kind of a BD. I know what you’re thinking and it’s okay…I had to Wiki it too. Also known as the caviar of the south, pimento cheese is like a relish/spread made with processed cheese, mayonnaise, and pimentos. And surprisingly it isn’t that bad.
  • Predicting the weather pattern here is more difficult than beating Adele at the Grammy’s. The first weekend I moved here there was a huge snow storm right after my plane landed and because it snows so infrequently, NC kind of goes into a frenzy and Durham basically shut down. I was literally stuck in my apartment unable to purchase any food and my rental car just sat snowed in on the driveway. Fortunately my gracious landlords fed me for two days until I finally hydroplaned my way to Trader Joe’s. Five days later it was 65 degrees with sunny skies. Bipolar, I tell you. Completely bipolar.
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  • Southern style fast food joints are all the rage. Bojangles, Chick-fil-A, Biscuitville, Waffle House, Cracker BarrelI, and Zaxby’s Fried Chicken are all within a quarter mile of each other on the road that leads to my neighborhood. How can all these fried chicken places stay in business in such close proximity of each other? I think one of these days I’ll have a biscuit showdown and make a day of stretching my waist line and discover who really makes the best frozen biscuits.

Overall, I know California will forever be my first and true love and will eventually wander back west. BUT I must admit that I cannot get over how amazing it is to drive a mere hour or two on the East Coast and end up over state lines. Out here I can explore multiple states without having to take an actual job there and this past weekend I was blessed to spend time with an old friend from my undergrad days at Fresno State.

Flashback to undergrad days: Pres and VP of our honors college program

 Jack is going to medical school in West Virginia and of our college circle of friends, we are the only two currently living this far east. In my opinion, West Virginia doesn’t seem to have a lot of exciting things to offer and I literally didn’t even have cellular service for a good 40 minutes during my drive up. For a Millennial, if there’s no Snapchat Geofilter available for a location, then it’s basically considered no man’s land, right? Ha kidding! However, I think both of us really needed it. We did this killer eight mile hike to McAfee Knob, drank too much wine while we relived Bulldog memories, and swapped medical life woes/stories. For me it was just so good to see a familiar face and for him, well med school has had his whole life on lock and this is the first weekend in months that he took a whole day from studying. Which to that I say, ughhh eww. Just thinking about being in nursing school again kind of makes me want to vomit.

If I don’t extend I only have eight more weeks here in NC so I guess I should start making a plan. I’ll keep y’all posted. Until then, go give your momma a Valentine’s call, love on your neighbor, and eat your body weight in chocolate.

Cheers and keep on wishin’!

Miriam