Conversation with Dr. Teresa Nyamora about her path to medicine, pediatric and adult neurosurgical conditions, the dream of housing residents on the Kijabe Hospital campus, her love for the Pan African Academy of Christian Surgeons, and desire to help her people.
"I want to be a doctor for African people. I want to work in Africa. There's so much healthcare need in this continent that if we, as the medics who've been trained, just stay around and work for our people, there will be a huge difference. Then we'll start becoming the policy makers. We'll be like, 'now we've worked in this place. We need to change this policy to this.' And then slowly by slowly, we'll see the change."
David: The next big project we're starting for Friends of Kijabe is housing. I think it will go well because everybody is excited about it. Everybody's involved in it. Everybody's wanting to happen. I don't think I'm going to ask you very much about housing, because really I'm more interested about what you're doing, what you're learning, some of your background. But then we'll use this just to share with people like, "this is the people who are going to live in this building. This is why they're special."
So to start, tell me your name and what you're doing in Kijabe.
Teresa: Teresa Nyansorora Nyamora is my name. I'm a neurosurgery resident. PGY1, but currently doing MCS. So, general surgery, orthopedics and everything. The first two years.
David: Okay, so explain that for for a person like me. So you do two years of general surgery, and then you transition to neurosurgery.
Teresa: So, you do two years of general surgery, which is not just general surgery, it has general surgery, orthopedics, ICU anesthesia, and I have neurosurgery rotation, um, for two years. And next year has research. And then after the first two years, then you become a fellow. So, then you get to do neurosurgery purely.
David: And so, for surgeons, there's kind of two tracks, right? There are some people that will do the full general surgery and then start on a neurosurgery program. And then you're doing what a lot of the pediatric surgeons have done where it's kind of accelerated. It's like a shorter general track and then more specified to your awesome. And so that's why that's why you're here before the program is officially started. Yes. So, by the time you're done with your two years.
Teresa: Yeah, the program will already be here.
David: Yeah. So, we're hopeful. So where are you from? Why are you in Kijabe? What led you to medicine?
Teresa: Where am I from? Where was I born? I was born in Nairobi. I was raised in Kisii, you know. Kisii. In the western region.
David: It's about like four hours from here.
Teresa: 4 or 5 hours from here? Yeah. Then I came back to Nairobi after my parents passed away. Then I was raised up in Nairobi once again. Why medicine? I think I've told you this before, but my mom used to be a village herbalist, so she was so much into herbal medication. She'd be called. She would also be an act as a midwife. So as a child, I was very young. She put me on her back in the middle of the night. We were going somewhere because she'd been called. Someone is not doing well. And I saw her do this, and this was my first five years of life by the way. So I was very young. Sometimes she would, um, send me to go and pick some leaves, which she would make into posters and, you know, just apply on someone's wound. I guess, if you ask me, I think that's where that all desire to become a doctor came from. But the main reason why medicine was she fell ill, and the hospital that she was taken to could not be able to treat whatever it was that she had. She had a swelling on her thigh and they weren't able to treat that.
Teresa: And so she was sent back home. And she passed away at home because of the complications of that. Right now, I can think of so many DDX's (differential diagnoses) of what she had. But I thought about it. I was like, if she had a specialist at the time, you know, if she had doctors who were knowledgeable in what she had,someone would have saved her life at the time. So, I guess from there, I was like, "I would like to become a doctor so that I am able to help people in those areas where there are no specialized doctors." You know, where the doctors are needed most. It's like, yeah, she could have gone to Nairobi and all, but at that time, it was back then, did we even have transport? What kind of transport did we have at the time? Because in the 90s. So yeah, that's why I think that's where the desire [started].
David: You were still very, very young.
Teresa: Yeah, I was still very young. I was five years. But I can remember because I was in the house with her throughout the time when she was sick. I was there when she passed away. We helped in preparing her for burial and everything. As a kid, I have a vivid memory of that. Yeah, yeah. But that's where the desire to be to do medicine came from.
David: And why are you interested in neurosurgery specifically?
Teresa: Well, neurosurgery. Once I was done with my internship here at Kijabe, I was offered the position of becoming a medical officer and neurosurgery. So, starting off, I was like, “yeah, I think, I think I want to do surgery, just not general surgery and not orthopedics,” because those are the two that I was exposed to. But I was like, "Lord, I don't know which which path you want me to take. All I know is that I want to work with my hands surgically, but I don't know exactly where you're leading." So, I took the job, um, and I started working. . .
David: And so, a pause real quick. . . a medical officer, you finished medical school? Then you do an internship. So, your internship was a Kijabe. And then, then you join the neurosurgery service as. . .
Teresa: A general practitioner? Yes. So, the first year, our neurosurgery surgeon was coming only two days a week, and then the following days I was taking care of the post-op patients. And so, I quickly learned, like, "So this patient has this. This is how I'm supposed to take care of the patient and all that." And with time, I grew a desire for neurosurgery.
But it was the children for me. We saw so many children with hydrocephalus, with spina bifida, and we would take care of them. We would do surgery on them, and then I would be left taking care of them in the wards and, you know, just talking to the parents, enlightening the parents about the condition of their child and then teaching them how to take care of their children because it's not just, "oh, yeah, you've done surgery and now your child is 100%." No, our children are not like that. It becomes like a lifelong thing that they have to live with. So just talking to them, encouraging them, praying with them over and over and over again, like, “Lord, I want to become a pediatric neurosurgeon.” That's where it was born from.
David: Awesome. I love that.
David: And so what will the what will the process be? I guess you'll do...this is general neurosurgery residency...and then will you do a pediatric specialization after that?
Teresa: I hope so. I pray so.
David: Or you can just pick it up along the way?
Teresa: Yeah, depending on how it is. So, right now I'm like, "okay, let me just do my neurosurgery and then see where and how God directs." The desire is still there. And so and I know it's not just he's the one who's put that seed in there, so he'll guide.
David: What are the causes of hydrocephalus and spina bifida?
Teresa: Okay. So let's start with hydrocephalus. In our setting, the hydrocephalus we see most is post-infectious like a child got, let's say, meningitis. And then there was a blockage in where the fluid which is the CSF (cerebrospinal fluid) flows through. And so they come in with um, with hydrocephalus, like there's excess accumulation of that fluid. And then the head starts becoming big. Other causes that I've seen are congenital, very few, but we have some who've been born with like an excess accumulation. And even for those, you find that there is an obstruction somewhere along the path where the fluid flows. And so ,then we go in and correct that. But then we have other causes, like trauma, like some children just got a bleed somewhere and then it blocked and then others you just don't know. Some point they, they either get some metabolic diseases and then they get hydrocephalus. But our commonest cause is infection. So you don't see them at birth. You see them, later on after they've gotten an infection. And then it comes as a secondary result.
David: In America or somewhere like that, they would catch that early, through well-child checks or a hospital related birth process. Right? But here it's I assume it's largely people from the village who maybe had a home birth and have not seen physicians.
Teresa: It's true. So that's what we see most. If you look at our patient population, you find most of them are either Maasais or they come from some place in the coast or just some villages that you know for sure if you ask them. "Um, how did you give birth at home? Did you take your child for any immunizations?" No.
"What happened?"
"The child started getting sick. I gave the child an over-the-counter medication, but they continued deteriorating. And so that's why I've decided to come."
They've not been going for wellness clinics where they would be picked earlier. And so that's why some of them end up having, debilitating issues. Because as much as we're correcting this, sometimes it's too late. Some of them have lost their sight already. So now we walk the journey with them after that.
David: Wow. So you can lose sight? Does it cause, I assume, CP (cerebral palsy) kind of related illness.
Teresa: Yeah. They can lose sight. They can get convulsions. Some of them, like you say, they can get some kind of CP features. I've seen some completely unable to work, especially when they come with massive hydrocephalus. So, they've also lost their ability to walk.
David: And that's just because the because of the fluid is just putting pressure on part of the brain that controls those functions.
Teresa: Yeah.
David: Okay.
Teresa: And most times also, as children, in the head, there has to be a balance between the brain the fluid and the blood. So, with the excessive fluid then you start losing some of the brain, like what we call the cortical mantle. Now it starts reducing to give space for the fluid to continue accumulating. And also, in that now, the children start losing their cognitive function.
David: And so, what is the treatment for that? (laughter) I'm asking you this because I watched Doctor Warf doing the surgery yesterday. But for somebody listening in, what is the treatment?
Teresa: So, if a child has not lost so much of the cortical mantle and then we go in and either put... so we do two things. We can put in a shunt which takes the excess fluid and takes it to the abdomen where it's absorbed. Or for some who have obstructive surplus, we can do something called an endoscopic third ventriculostomy, an ETV, where we just go in and create a path, aside from the one where it was blocked, create a path for it to continue with its normal flow.
David: And so, the ETV, this is kind of a newer procedure, right?
Teresa: Yeah. I think for us, we've been doing it the past four years. We got our, um, flexible endoscope I think two years ago or a year ago. So, it's not something that so many surgeons know how to do. And so, I'm actually so grateful that we have Dr. Copeland. Dr. Copeland actually teaches very well how to do the endoscopic third ventriculostomy. And if you are able to do an ETV, it saves the child from an implant because a shunt is an implant and an implants have so many complications on and off. And we've seen so good outcomes with ETVs. Yeah.
David: And what I read was this is something that was pioneered in Uganda, right?
Teresa: Yeah.
David: That's amazing. And now it's becoming a standard around the world?
Teresa: Yeah. Now, I think of it is for once, something that was pioneered from Africa. I think it was started at CURE Uganda. And, they've done research. So, if you read at their, their papers when they're looking at the outcomes also, that's where you see. Yeah, the outcomes are good. Also, prognosis-wise, how the children are growing because we follow them up long term and they're doing very well
David: Awesome.
How does follow up work? Because I guess you're dealing with the same problem as they have coming in the first place, right? Is it phone follow up or do you try to get them back for visits if possible?
Teresa: So, we have follow-ups in two ways. All of the follow-ups are physical, but the mothers have our numbers, and they call regularly to check in. "Oh, my child is is doing well or this is happening. What should I do?" So first the first almost 6 or 7 clinics, they come back to our clinic. The first the first clinic is mandatory. After surgery, they have to come back to our clinic. The first and second clinics. We advise that they come back. We see how they're doing. First clinic is after two weeks. The next clinic is like after a month after surgery.
Teresa: After that, we have the Bethany Kids Mobile Clinic team. So, we use the mobile clinic team. Once they go to these areas, we connect them to the clinics. We tell them that these are the dates. This is where our team will be. We need them to be seen by our team so that, um, because our team is also trained on what what are we looking at in these children? They do like a head circumference. They ask them some questions on how are they doing? “Are they feeding well?” “Are they vomiting?”” Are they convulsing?” Are they convulsions well controlled with medication? What's happening. And then if they have any issue they call us directly. They're like, "oh, so this child you did surgery on this day and this day. This is how they're doing. We think the head circumference is increasing."
Teresa: So we know there's a failure somewhere. Or we think, "oh, there's a wound, we can see the shunt or something.” So we know there's a complication." We tell them, "bring them back immediately, ask them to come back immediately so that we can..." Sometimes they just go in and...
Teresa: Now they've been put in into support groups. So there are moms who have children with hydrocephalus, moms who have children with spina bifida. They support each other even in their villages. Even without us being there. And so, there's one person from the group who will report on the progress of these children. "Oh yeah, this happened to this one. This is happening to this one."
Teresa: I think that's the part of follow up that I love the most. The mobile clinic, it does what we can't do because we, we can't get to the villages all the time. And what they do is just way above and beyond. And sometimes when you get time to go and do the the clinics, then you get to actually see where they come from and you get to understand, yeah, they could not have gotten to the clinics. You are compassionate when they come back to clinic, you're like, "yeah, I'm so sorry. I understand you couldn't get to the hospital."
David: Yeah I like that. So that's hydrocephalus...and spina bifida bifida?
Teresa: Spina bifida is very different from hydrocephalus in that its cause is 100% congenital, and it's normally because, the Mom’s system does not have enough folic acid, which is required in some enzymes. When neural tube is being formed, which is the spinal cord and the brain, lack of that important "vitamin" causes there to be a space. So spina bifida is like a space in the spine, you know, like a split spine. So instead of the spinal cord closing, fusing normally. So, it gets to a point where there's a space and then some of the spinal cord is outside its closure, its membrane. The problem with that is that whatever is out is not functional. So, you find some of them have it covered with a thin film of material, or sometimes it's just open and it's leaking some spinal fluid. That one, well, it's something that can be prevented. And I think that's where conversations started with the Health Ministry at some point. That's why right now, if you look at our packeted like flour, I've seen even rice and pastas, they've started fortifying them because of this.
Teresa: If you think about it, most of our people in the villages do not eat foods that are from packets. “It's maize. I plant my maize, I take it to the posho mill, it's ground and that's it.”
So, we don't think like, "oh yeah, green leafy vegetables, do I eat them every day? Do I know whether I'm getting enough?"
Teresa: And as women, especially of reproductive age, folic acid is usually lower...and These women require folic acid way before they even get pregnant. And so, by the time they even realize they're pregnant, they're way past their first trimester, which is usually the most important trimester that requires their folic acid. And so, by the time they're coming, the children are already have neural tube defects. They have spina bifida or some of them, you find them having what we call encephalocele here or an occipital encephalocele where it's open right up here. So, yeah, that one is more genetic nutritional deficiencies than it is infection.
David: And so, [spina bifida] affects the poor much more than...?
Teresa: Yeah, it does. If you look at our patient population and their socioeconomic factors, most of our spinal bifida children are actually from the lower socioeconomic status families than higher socioeconomics.
David: If I remember correctly, I think Dr. Albright was really involved in advocating for the supplements or the fortified different things. But I mean, it wasn't so long ago when he was here that was probably like late 2008, 2009, 2010. So it's better, but still not where it could be.
David: I think that's the summation of it. If you want to know the summation of Kenyan health care: It is better, but not where it could be. Anything we talk about.
Teresa: Yeah. Currently for our mobile clinics, our moms who have children with spina bifida are actually given folic acid. [Part of] their follow up is giving folic acid. Their thoughts on why are you taking this? They go for pre-conception counseling. Because we know they're not going to go to the doctors for this. And we've seen an improvement. We've not seen any family having a repeat. It's not a genetic thing. So you don't see a repeat of oh yeah, we have two, two family members, two children who have spina bifida. I also attribute it to all the work that is done with the advice that is given to these moms with the follow up.
Teresa: And, by the way, you know, in African culture, if a mom gives birth to a child who is not fully okay, the blame is put on the mom - all the time, every single time.
Teresa: And so, these moms also come to us with the same feeling. They always have that guilt. "Daktari, I know I am the cause of my child being like this. What do I do?"
So just getting them to a point of understanding that sometimes it's not up to you. What you're handed is is way above what you you can change, you know, and also, now involving the dads and reminding the dads it's not the mom's fault. It's a beautiful journey to walk with this one. So, you see why I love pediatric neurosurgery? It also has that social aspect that I feel like it's an opportunity to give back to the community.
David: What about what about adults? (Laughter)
David: I'm a little more familiar with children just because my wife Arianna is in the pediatric ICU a lot of times. But yeah, what brings adults in for neurosurgery?
Teresa: What brings adults in? So, by the time we're getting adults, it's because they've gone somewhere else and they've been told, "oh, yeah, you have a tumor in your brain." Or, they were involved in an accident and they have a head injury or a traumatic brain injury. Rarely, we get them because of infections. But mostly if I look at our population, most of them is because of tumors and because of traumas. Tumors and traumas.
David: Tumors and traumas.
David: So, if I am sitting in the State House and I just launched a new insurance program where I have to pay for anybody without considering pre-existing conditions, you know what the very first thing I would do, I would launch a helmet law.
Teresa: Yes, please! I would do that. I would do that.
David: How can it be that all these guys are riding around on bodas (motorcycle taxi) with no helmets?
Teresa: Yeah. Um, thinking of it, I'm very, very guilty. Because as a passenger in those motorbikes, every single day, I just pray like "Lord, please, Lord, please. I do not want to be a patient in the same casualty where I am working." That's my prayer. I'll do the same exact thing because you see less head injuries with a helmeted drivers than with the ones who did not have a helmet.
David: So. . .you have to do a research project next year, right?
Teresa: Yes. (laughter)
David: Maybe we could start with Kijabe staff? Protecting our people? I know it's hard. It's there's some things that can be changed by behavior...talking and counseling and culture change. But then there are certain things that are easier to change by making it a rule. Even in America, most states have motorcycle helmet laws, but like South Carolina, where I went to college, there we called motorcycles "donor cycles" because there's huge organ donation in America, I think a lot of them come from come from motorcycle accidents.
Teresa: Because by the time the accidents are done, they come with severe traumatic brain injury, or they come brain dead already. There's nothing you can do about it. Yeah. It's done.
Teresa:I hope one day we get to where Rwanda is. Like in Rwanda, all motorcycle drivers have to have two helmets, the ends and the passengers. It's a rule. So when I went to visit in Rwanda, I was like, "Wow, I'm being given a helmet. This is really nice." I was so shocked. And the guy was like, why are you so shocked about it? I'm like, yeah, yeah. We come from places where that's not common place. Yeah, it's a set rule.
David: It's so possible. I hope we can do that. A lot of things that Rwanda does will spread. Yeah, that's why we have no plastic bags.
David: So what else should we talk about? What should I know about medicine and life?
David: All right, I'll tell you one of my other dreams. I would love to see the mobile clinics involve other specialties. And I know it's complicated because there's different organizations and funding and paying staff to not be in the hospital and driving across the country is hard. But anytime I look around, we have all these organizations that care about Kijabe, we can always do more together than we can do individually.
Teresa: Individually.
David: I agree. And so, we have one team going out to like do hydrocephalus and spina bifida from Bethany Kids. We have another one going from CURE to a different place, maybe even nearby, doing ortho. Yeah. But then there's tons of other medical needs in that same community. Is somebody seeing the diabetic people? Is somebody seeing whatever needs to be looked at? So that's something that's beyond my pay grade. But I would love to see happen. I would love to see these efforts combine.
Teresa: Come together. . .Because I feel like they actually do a lot and they get to a population, that does not get to the hospital. They are the ones who make sure that that population that does not [normally] get to the hospital comes to the hospital. But imagine if, yes, we're going in with any kids.
When it [Bethany Kids] started, they were going for the pediatric surgery babies. And then later on with the efforts that were put in with by the likes of Dr. Albright [and Dick Bransford], they were advocating also for like spina bifida and hydrocephalus children. And with that, so we've gotten quite a population of pediatric surgery or children with surgical issues. And then cure comes in, CURE takes over the children with orthopedic issues. But I agree with you because now there are other conditions that are not picked that, if we supported through this, instead of just going individually...like if you go to this place other than doing orthopedics, you can also check we can also have a staff checking this or this and this. It will be really good. We would reach millions and millions.
David: Great dream. I like that, reach millions and millions. That's what we need to to pitch to the leadership.
Teresa: Yeah.
David: If the goal is to reach a million lives for Christ.
Teresa: Yeah.
David: And it's also a thing that as you're studying neurosurgery and Kijabe. Right? Like, this is the very, very top of the top of the health system in Kenya. But yet, the people you're doing that for. . .the reason they're here is because on the very, very it's even below primary care. It's community health. Whatever is available is not reaching them.
I think our biggest challenge in Kijabe is how do we connect these tertiary care technical capabilities. You guys do amazing things in Kijabe, amazing surgery. You can operate at a level comparable with anywhere in the world. But how does a normal person come when they need to come at the right time? And ideally...when I say at the right time...I mean, with a lot of these things you're treating, ideally if they would not come. You know, if you realize the child has an infection, they have meningitis, if they if they come immediately, then you don't have to do surgery six months later.
If I was to ask like, "what is our biggest challenge in the Kenyan health system?" It is how do you connect these? Because there are even in Nairobi, there's great hospitals, there's awesome hospitals growing in western Kenya, in many different places.
How does the bottom of the health system connect to the top of the health system?
Teresa: I think we're lacking in between. So, if I go to the health center, the health center just has one nurse. The nurse is only trained in midwifery and only if its normal births. If it's a surgical birth, they are not trained in that. So now you see where the gap starts from. It starts from that. So, they're not trained to see other issues that the person comes with. "Like ah no, no you need you need a higher [level of care] you need to go to another hospital."
"Then I go sit down and think, I don't have money to get to that other hospital. I know this other hospital will help me, but I don't have the money. So let me stay with this disease for quite a while."
Teresa: That's why, like, even in adults, the ones who are coming in with tumors, the tumors are really large. They really spread because they've been having this headache for a prolonged period of time. "But, you know, Daktari, I was yes, I was sent to a neurosurgery, a neurosurgeon, but that is very far. But I do not have money for transport. Oh, but I did not have money for MRIs or CT scans."
Like, if we make sure that our health system from down here, we have the qualified personnel who need to be here, who can pick something up and refer as needed as fast as possible, then we stop having these gaps in between. If we train our community health workers and like, "oh, yeah, when you go to visit these people, if you see this, then you know, this is not supposed to be at home."
You need to advise them. I, as a patient, would listen to my community health worker first before I listen to someone from a clinic. I feel like there is training needed. There is personnel needed. Of course, there are lots of funds needed. Like you said, we actually all need to work as one together. The government and everyone else, just to make sure that we cover these gaps. Because this gap will always be there if we don't try to fill in in between. That's why I want, once I'm done with training, I want to go. Can I fill one of these gaps? Can you at least give me this equipment to allow me to fill this one gap, this place, so that we don't get everyone coming to only one place? Because there is no such kind of specialty where they are from. That's why we get children from Sudan.
David: I'm working on, today, they're sending a child from Togo for ENT surgery.
That's far! It's on a different ocean.
Teresa: Yeah. Yeah. So it's not just even Kenya. It's the fact that we in Africa. And that's why I love everything about PAACS train for the African community, you know?
David: Oh, yeah. Thank you. I missed one of the most important parts of our conversation is PAACS. Yes. Pan-African Academy of Christian Surgeons? Yes. Awesome. Tell me a little bit about PAACS. How do you. How do you see it?
Teresa: I see it as, you know, the way you say "I have a dream." I see it as the one organization that had a dream for Africa that, I think even we as Africans did not think about before.
I think most times in training, especially in medicine, you're going to train. You're like, “yeah, I want to finish, I want to make money. I want to go where I can make money.”
And so that's why if you look at our Kenya medical field, most of us are, are like, "okay, let me let me just finish." Do these exams go work in the UK or go train in the US or do that?
But then someone came and worked in Africa was like, "no, no, no, we need to train our African doctors for African people in Africa, in Africa because they saw the need that is there."
And so even as much as I can say, "oh yeah, let's be going for short missions and in Africa and do this and that." That's not adequate. That's not long term. Then you leave the patients who will follow them up? More patients will keep coming. Who will do this?
And so just that one goal and one one vision of PAACS is the reason why I fell in love with PAACS. It's the reason why I applied to PAACS.
Teresa: I want to be a doctor for African people. I want to work in Africa. There's so much healthcare need in this continent that if we, as the medics who've been trained, just stay around and work for our people, there will be a huge difference. Then we'll start becoming the policy makers. We'll be like, “now we've worked in this place. We need to change this policy to this." And then slowly by slowly, we'll see the change.
Teresa: But we won't see that change if all of us want to "let me just want to work in Nairobi.” “No, I just want to go and work abroad." We won't see any of that.
But most of all, I just want to see my people get better. Health wise.
David: That's a good answer.
Teresa: And also, in fact that all the time I keep saying this, there's no organization that has such a holistic kind of training. So, someone is checking up on me and saying, okay, how are you doing in your training? Are you achieving this? Have you achieved this your your objectives for this month? Have you achieved those objectives? That is all well and good.
But there's also someone who keeps asking me, "how is your walk with Christ?" "I know things are not okay." "Do you have a mentor?" You know, "how can we pray for you?" There is no other training that offers that nowhere on earth. No other training that offers such its only PAACS. So, it gives me a whole rounded kind of training. I'm rooted in Christ, being trained. I'm actually getting the best of the best training, because I get training from way many people who've worked in very many different areas in this world who have so like a wide span of experience. I'm also mentally [supported] - there's someone checking in on me, like, "do you need to see a psychologist?" There is a psychologist who's been who's specifically for us as the residents who are training. You know, that's not common. That's something very different. And it's something I do not take for granted. So, I end up coming out as a holistic kind of doctor who's more compassionate, who has a better way of approaching patients, because I have gotten all this aspect of training and not just one aspect of training.
David: And the and the part you didn't mention, but I know it's a big deal going forward in Kijabe they're working on developing right now is a leadership development. It has always happened. I mean, our, our CEO is a PAACS graduate. Our previous CEO is a PAACS graduate. I mean, I think if you go around to any of the mission hospitals, most of them have connections to PAACS. But development of Christian healthcare leaders is a big deal.
Teresa: It is. It actually is. Those leaders are also the ones who are changing how things are, are happening in these hospitals and not just in these hospitals, because now, as a hospital, you're not an ecosystem on your own. You have to work with other hospitals and also with the government. And imagine you have a Christian leader right there who is very well trained, who is in sitting inside in this meeting with these people. Some of them don't even know Christ or some of them have not been through such kind of training, and they are getting this wisdom that's coming from this leader. So, they are just sources of change everywhere.
David: And this is part of why we want to support this resident housing complex in Kijabe. I'm not sure how many actual residents will hold. I mean, theoretically it'll have 90 bedrooms, so there's a lot of bedrooms. But then, you know, some people are single, some are married, some have kids, some don't have kids, so it will change as it goes along, exactly who and why and how.
But when you talk about mentorship and community and development, if we're together - because all of your all of your faculty, all of your mentors live on campus, right? But you're kind of scattered in the community right now, right?
Like, do you live in Maingi?
Teresa: I live in Kimende.
David: Oh my goodness. Yeah. So that's a matatu plus a bodaboda down [to Kijabe]. So, at least an hour commute. It would be, it would be awesome when you just when you're here.
Teresa: It would be. So, you see some of the departments like have a resident's Bible study. You guys can do that. We either do a Bible study early in the morning, but like even get-togethers, it's very hard to bring us all together when I say, but "I mean, this thing is ending at what time? At 9 p.m.? I can't."
How do I get back home? I have to consider that.
David: And if you are trying to get to rounds by like 6:00 a.m.,how do you do? You can't do a Bible study before that.
Teresa: You can't do it. Yeah, I can do that. What I do is wake up at 3 a.m. so that I'm able to have my quiet time and then do a bit of stuff before I get out of my house, like at 5:30 or even earlier, so that I can be able to be in the hospital by 6 or 6:15. And sometimes that's not even possible because you don't get a matatu (minibus) immediately. You have to wait for a while, and then if you get to go earlier, there are no motorbikes. In fact, even if you call your motorbike guy, they'll be like, "ah, it's too early." You know?
So, it will be really good to have housing on this end. One for community sake. I feel like we are not as close together as residents are. If the residents who actually live around each other, uh, to also because of the timing it takes to get to the hospital. And it's expensive, actually. Motorbikes are expensive. So that, and also, you sometimes you get you're tired, like you're tired. You're just done this on that road. On this road coming down.
David: Because essentially, I mean, you're starting you're starting your day with your commute at 6 a.m. yeah. When do you finish here? Like 5 or 6 or just whenever surgeries are done?
Teresa: Yeah. Whenever surgeries are done.
David: So you're working...At least it's a 12 hour day.
Teresa: Most days it is. Yeah.
David: It would be nice to be close.
Teresa: It would be nice to be close.
David: Hope we can make it happen.
Teresa: We will keep praying, you know? Yes. Depending on how God leads. When God leads and he'll keep providing, it will happen. It will happen in God's timing.
David: And it will happen. I think I think you will be one of the residents [to live on campus]. I think it will happen in your time in Kijabe. So hopefully very soonf all goes to plan.
David: After the after the college classroom building is finished, then this would be the next [project] to start.
You're amazing. Thank you so much. Pleasure talking to you.
Teresa: Pleasure talking to you, too.