If first impressions mean anything, then this trip to Kenya will be one I will always remember. Not that I expected anything less. We arrived at Kijabe about one week ago, and there already are a number of things that have awe-struck me. But perhaps what has stood out more than anything to me is the people here. While many of them have little in the way of possessions, you couldn't find a more happy, gracious, or appreciative people, making this journey all the more special.

After quickly getting oriented to the operating room here, our activities thus far have consisted of providing anesthesia for a large variety of patients: including parturients, elderly, and children. We have witnessed pathology here that you would rarely see in the States: large bilateral cleft palettes, two myelomeningocele defects in one patient, etc. There is also a large amount of trauma here, and a high volume of orthopedic surgery. We have been teaching and refining some of the nurse anesthetist's skills at regional anesthesia, providing an option for patients to avoid general anesthesia and developing another means for postoperative pain control. We have also spent a lot of time teaching the student anesthetists, including conducting oral and practical exams for them.

Lastly, I have attached a picture of the ICU nurses after Humphrey Lam (the other resident that is here with me) and I delivered some medical supplies. The big balls of white are all pulse oximeters—giving the ability to monitor patient's oxygenation—something that is not always easy to come by here. One of the nurses was so excited when we dropped off the supplies, she couldn't stop jumping up and down. It's moments like these that make you realize how rewarding this opportunity is to be here.