Nurse in Kenya: sand in my fingers

"Time changes everything except something within us that is always surprised by change." - Thomas Hardy

I wonder if each week’s blog will come later than the week prior; time seems to slip through my fingers and leave me in the dust lately. As usual there’s a lot to be done in seemingly too little time. I, of course, am the one deciding what to do with my time: I am learning more everyday about what is required in “making” the time instead of “finding” the time for tasks. Writing requires a lot of focused attention, and with more than one-hundred-and-thirty children now, sitting down to write has simply not been my priority. Sometimes it’s easy to get caught up in some moments, deliberately bypass a few more, and completely miss others. I’d say that I’m practicing a new time of time-management, but really, I think that time is managing or practicing me.

This week was mostly like other weeks: plenty of minor injuries, another bee sting, and one girl suffered a spoon-related laceration to the bridge of her nose. There was actually a very welcome lull in the infantile malaria and we thanked God for a three-day run of a lack of acute illness.

After the lull, though, I had a bad scare with one of the babies. Chris, the first baby I helped welcome since my return in June, was found to be in respiratory distress the other night. Ray and I were up late with him trying different things to improve his work of breathing, to get him through the night until we could take him to the clinic in the morning. He demonstrated more accessory muscle use than I’ve ever seen in a baby (using extra muscles to breathe, meaning that air movement is difficult) and I was confident that had we been in the first world, he would have been admitted to the hospital. I was grateful to see that he was still oxygenating well (I brought a pulse oximeter) and am glad that he didn’t have to work too hard for too long – with medication, proper positioning, chest physiotherapy, and prayer, his condition is improving. Some of the missionary staff thought one of my unorthodox techniques of soothing his breathing to be funny: I held him in front of the open freezer door, remembering that cool and moist air can help with certain types of pediatric respiratory issues (it worked well). Of course, the boy still eats and eats all the while (a good sign) – he has nearly doubled in size in his time here – he was severely malnourished when he arrived with obviously stunted growth.

The missionary staff celebrated “Christmas in July” on the 25^th; it was a pleasant diversion from the norm. The hospitality room was decorated with a few red and green balloons, two strands of silver tinsel, and two-dimensional “stockings” made on loose-leaf paper, taped to the wall in the corner above a virtual fireplace on one of our Macbooks. We listened to Christmas music all day and read the Nativity scriptures. I even burnt some pudding on the stove. We exchanged a few silly gifts and a few of us watched Elf in the dorm. It set a steep precedent for future Merry Unchristmases.

Out of all the fun things we did on Christmas in July, two things happened that really put the icing on the cake. First, one of the older boys [was] returned home after having run away for some time, seemingly with an attitude “adjustment” after having spent some time away from the home experiencing the consequences of his choices. I had been feeling for a week or two prior like he was weighing heavily on my heart and had just prayed that he be sent home if that was what God wanted. Secondly, and most “coincidental” (yeah, right) was the arrival of a new baby. I saw Mama Carla and Madam Beth Ann arrive home after ladies’ Bible study (I stayed home so I could go on the clinic run, to ask the doctors if me being tired still was active malaria or post-malaria fall-out) with a baby wrapped in a red blanket I didn’t recognize. They came home from the Childrens’ Office with a literal bundle of joy – a healthy baby boy just a few months old. He came from the office in a white onesie with a Christmas pattern on it. Not kidding. He was named Noel. God gave us a few Christmas gifts, even though it wasn’t “really” Christmas. It’s silly little “coincidences” like that which lead me to believe that He really knows what’s going on “down here”, even in our trivial day-to-day frivolities.

Time is a funny thing. Timing, too, seems like its own animal, with its own spirit. Why do some events take place throughout the course of a day at one moment or another? Was that baby coming home to us wrapped up like a Christmas gift, in the most obvious sense, really God giving us a little nod or a wink? Was it just a coincidence? Scientifically, I don’t know, and I don’t care either. Faith-wise, I know what I believe in my heart. Regardless of its significance as a coincidence or a miracle, there is one tiny little man who has a name that he wouldn’t have received on any other day (I’m assuming the Childrens’ Office is closed on Christmas Day). He’ll grow up with that name and it’ll all be because of the timing.

I’ve spent a lot of time this week thinking about time. Obviously, as I mentioned earlier, I’ve been crazy busy. I’m trying to take on new responsibilities (even small things, like blending down the food for the boys with cerebral palsy at lunchtime so that the preschool teacher can have a true break; it takes ten minutes to make and clean everything, no big deal) while still broadening and deepening my nursing care of the kids. I’m trying to ask more questions about their medications, learn more about any medical conditions they have, and anticipate problems or issues unique to this population. Issues I’ve been trying to focus on this week are pediatric corticosteroid dependence (like prednisone) and withdrawal, management of infantile respiratory distress in a resource-limited setting, and pathologies of self-image during puberty and adolescence in kids with abandonment/abuse issues. Then there are always unanticipated surprises: one morning Ray, Rachele and I took seven babies (between the three of us) to the immunization dispensary for routine vaccinations – one of the little girls had diarrhea (yep, I’m talking about this; I thought you learned by now not to eat while reading my blog?) all over herself, on and through my skirt, and then again all over the front seat of one of the vehicles as a frantically attempted to contain the “warp core breech”. Also this week I had to learn more about burn care after a few of the kitchen aunties accidentally were scalded in the face, eyes, and feet by hot cooking oil. Adam has been welding a frame for a floral trellis for the bougainvillea bushes out front and one of the aunties also sustained a corneal burn from looking at the arc-welder. Time management has taken on a whole new meaning for several reasons.

Being the Nurse at In Step is my “job” but it’s also my life. It’s not a job I ever leave. The answer to the question, “what hours are you scheduled to work?” is “yes.” I work here to take care of the kids, but I also live here and have to take care of myself. I wonder if this is what it’s like to be a mom – there are a hundred thousand things to do and if you look at all of the tasks at once, or think about doing them “day after day” it can be overwhelming or seem like a daunting task, but remembering whom you are doing it for makes all the difference. As I continue to build relationships with more of the children, time management decisions are much simpler to make.

Living here also means that I have to set aside downtime. When I say that I’m “crazy busy”, sometimes I am busy just setting aside time to watch a movie, goof around, pray, or sleep. It’s a hard balance for me because I feel like I should always be doing something “productive” and I am learning more each day that I can’t just keep the wheels turning every waking hour without consequences – sometimes just spending time with the other missionaries, or snuggling a baby on the couch, or taking a nap, is just what is required next.

The timing of our day-to-day tasks can really change the shape of one’s life. I feel that way here: how I choose to spend my time really does build what my life here looks like. The more time I spend with one child, the more of a relationship we build, and that affects how we each feel about each other and about ourselves. Similarly, the opposite is true. The same goes with the other missionary staff, except the time we spend doesn’t just build our interpersonal relationships, but it also affects our ability to work together as coworkers to tackle problems, resolve issues, and brainstorm solutions. Even though there are so many elements in the day that our out of our control, the way we choose to spend our “free time” really does dictate the course of the day. It’s obvious, I know, but here it’s in such a new context that I feel like I have to re-learn the rules of life all over again.

Speaking of time spiritually, there’s much I could say about “God’s timing.” For so long I despised this phrase when it was thrown at me because I thought meant I would have to wait a long time for something I wanted – like a kid waiting on Santa Claus. I was reminded of this phrase when I was preparing to come to Kenya; it had seemed like an eternity for so long and then for the last few weeks before leaving I felt like digging in my heels and pulling on the reigns with all my might to slow time down. Lately, with time running through my hands like hourglass sand, I feel like I am balancing on the cusp of a wave I’m sure will crash, but never does; I’m have faith that I’m coming into a new chapter of my life here in a few major ways. Just when I think I’ve got God’s intentions and timing figured out, He surprises me with opportunities I could have just barely dreamed of, at moments I would not have waited for, or would have rushed through instead.

I want to do what’s right in front of me today – in a few minutes it will be rushing to post this blog and a few pictures before going with a few boys to the clinic. One, who usually doesn’t complain, has a stomachache and hasn’t been obedient in the use of his mosquito net and I wouldn’t be surprised if his blood smear was positive; the other has some kind of facial bacterial skin infection with badly inflamed lymph nodes in his neck. When we get home I’ll do what I can to make sure all the evening meds are prepared and administered properly, try to put away a bunch of laundry (I’m in charge of hospitality, too), deal with a few boils that are “ready”, slather a few kids with hydrocortisone cream (there was an army of angry biting ants on the field the other day) and then try to look presentable to go out with Ray for a dinner with some lovely visitors from his church who are staying in Kitale. When we get home I’m sure someone will be sick, there will be more meds to give out, and I’ll be exhausted, and not want to go to bed.

It is a busy life and has been for a while. It’s a tiring life and has been for a while. It’s a fun life and has been for a while. Some things don’t change. Some things do change, though. Life used to be much more confusing – even just a few weeks ago – and I feel like God’s timing is revealing itself to me every day, deep down in my heart, and right in front of my eyes. I can try to manage my own time all I want, but at the end of the day and with the start of the next, I’d much prefer to give the job to Him.