1. Walking Distance
At Tenwek, everything I would need on a daily basis was within a 15 minute walking distance: the hospital, the church, all my friends' houses and several small dukas (shops - where I could get phone cards, sugar, cooking oil, fresh produce). Though I hated walking up the steep hill at a high altitude to work every morning (or in the middle of the night), I now miss being about to walk to get somewhere. Here in the US, I drive everywhere - work, store, to meet friends. I have to schedule walking. Tonight, I need to go for a walk. Suddenly, that seems crazy!
Seasons are overrated. Seriously. Variety in weather is not the spice of life. Year around temperatures of 55 to 85 degrees F - that is just heaven!
Tenwek is about 0.5 degrees south of the equator (it runs through the country near Mt. Kenya) and the altitude is ~ 7000 feet. This means that the days are basically the same length all year around and the tempatures do not widely fluctuate. I have always said that Tenwek has 2 seasons- night and day, because any weather changes seem fairly unremarkable.
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| The stable weather in Kenya allows beautiful flowers like these to be grown everywhere, all year around, hence they are VERY affordable. |
Despite the lovely temperatures, Kenyans seem to have a very different cold threshhold than Americans. They get very cold and are wearing multiple layers while the missionaries are running around in just maybe a long sleeved t-shirt.
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| One of the hospital guards at Tenwek dressed for the cool night air. Okay...maybe this is really not a picture from Kenya - but you get the idea. |
3. Rain
You might think that I should have included this under #2, but the rains in Tenwek are a very different memory to me. I remember lying in bed at night and hearing the steady rain on the metal roof of my house lulling me to sleep. The way it would start so suddenly and ferociously on my afternoon walks home....soaking through my white coat....beading on the green fields and trees. It was life-giving rain, comforting rain. Rains that people needed for their crops, for drinking and it seemed to help wash away the stress and dirtiness of the day.
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| Love, love this picture! |
Other honorable mentions.....
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| Delicious home-cooked meals (that I did not cook) .......*missing Sara, my house helper!* |
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| Chai time with friends and co-workers.....a lovely time of learning, laughing and fellowship |
i miss all of these things too!!!!!
ReplyDeleteAnd of course Tedders and I miss our roommate!!!
DeleteI have loved poking around your blog. You seem like a very competent OB, and it sounds like you've done c-sections in a lot of seriously emergent situations. I am curious as to what your thoughts on VBAC are, especially as you return to the states, where this is a raging debate in the OB/midwife community. Are there certain stipulations you believe should be in place for a VBAC (continuous monitoring, IV in place, etc.) Just curious! :)
ReplyDeleteAnonymous -
DeleteThanks for reading! I am very supportive of women being able to VBAC and am willing to spend extra hours at the hospital to allow this.
Promoting VBAC safety begins like everything else - with education and taking a good history.
I look at the negative and positive predictors of success and investigate - as best i can - the cause of the previous c section.
Clinical pelvimetry and estimated fetal are important in making an educated recommendation also.
In the end....if the patient chooses VBAC...anesthesia and a physician should be immediately avaiable (in house). Likewise, they should have at least a saline lock.
In the cases of patients wanting a non intervential birth.....I would say...I will do my best to accomodate you...but in all things there is a degree of compromise. Continuous monitoring, a saline lock.....not the worst of evils. Home birth in the US for a VBAC - out of the question. Sure - if it goes well everyone is a hero.....but if it doesn't go well.....then you become a defendent....
Hope this helps!