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S  t  r  e  t  c  h  i  n  g   days and nights at the hospital.  This is our monthly weekend on-call.  The paeds service suddenly ballooned to 40-plus patients, half NICU and half older babies and children on the Paeds ward.  Just when we lost our visiting professor and when our Kenyan paediatrician colleague took a week off to teach elsewhere, of course . . . And hardly any of these kids are straightforward cases with solvable problems.  My head is still spinning in spite of hours reviewing and examining them yesterday and today.  Thankfully we're on call with two bright and competent interns.  So when one called Scott at 2 am for help with a breech delivery, and the other called me twenty minutes later just saying "please come", we knew we were in trouble.  A mother trying to deliver twins, first one became lodged bottom-first, compressing the cord in a situation that could easily have ended in death.

Esther, floppy as a fish, dressed in blue, with sparkling brown eyes that follow our movements, a babbling tongue.  She's a normal 1 year old mentally, trapped in a body that barely moves.  Her mother died giving birth, so her stout and steady, coarse-featured competent grandmother stepped in to rescue her.  For a year she's been feeding, bathing, carrying this child, who grew in size and responsiveness but never managed to hold up her head, to sit, to play, to crawl.  As a last ditch effort, her grandmother accepted money from a friend to travel across the country to Kijabe, determined to hope.  Instead she ended up with me, hand on her shoulder, as she wiped the tears subtly with a blanket edge, then broke down in sobs.  Esther seems to have a form of muscular dystrophy, and is unlikely to survive very long here.  She will never do very much.  I hated watching this dignified older Kenyan lady sob, hated being the one to bring her dream of cure to an end.

It is raining, incessantly, the kind of build-your-ark drenching that leaves us with a muddy floor, damp clothes draped over chairs, and a harrowing ride back from the airport last night as many cars stalled in the gushing rivers that flooded Nairobi's streets. ( You have to be in a foot or two of water on a major highway, being sprayed by trucks, slipping in the dark, to realize how important it is to think through where all the water which falls should go, and how important engineers are!). Rain does NOT make me happy. But it makes everyone else happy. Thankfulness for the rain is the first phrase out of everyone's prayer mouth this week, Kenyans, missionary kids. They get it, that we need this moisture to eat, to survive. I am cold, and would like to see the sun, and dreading standing in the rain to watch soccer all day and to cook pizza for Acacia's party tonight.

Kenya invaded Somalia this week, and President Kibaki officially declared a state of war.  It is a peculiar war, waged by Kenyan military across their border in cooperation with the weak government in Mogadishu against the kidnapers and insurgents who control much of the territory in between.  The reality of this is pretty far removed from idyllic Kijabe.  Pretty far, but not completely.  Today as I walked to the market with Acacia, I saw police stopping and checking vehicles as they approached the hospital.  Our neighbor pointed out that  one was wearing blue flip-flops with his blue police uniform which cut into the intimidation factor a bit.  Emails are circulating about security awareness, because Al-Sha_bab has threatened to bring their campaign of terror and bombs to Nairobi in retaliation.