So I have moved temporarily for the week to the Mariine Maternity Nursing Home outside of Nyeri to work with Josephine Gikunja. I will go back to Samaria next week while Susan attends a training workshop. Susan has enlisted the services of a Medical Officer (Physicians’ Assistant) to work with me and help with translation.

Josephine started Mariine clinic in 1963 and just celebrated her 77th birthday. Marrine means swamp because the location was called a swamp. For all my midwife colleagues, this clinic is like “The Farm” in longevity and success in maternal and infant care. Josephine, like Susan, is a midwife and a family nurse practitioner. As far as I can tell, Mariine clinic never closes. If there is a laboring or postpartum mother, Josephine sleeps on the ward.


I am happy to report that a baby was delivered at the very last minute of Thanksgiving Day. No fancy scrubs at Mariine for a delivery. We donned plastic rain ponchos with hoods and long plastic aprons for the event. After a short and uneventful labor, this Gravida 1 mother delivered a baby that tipped the scales at half of what I weighed at birth, small but none the worse for wear. I was sure that with the labor we were in it for the long-haul. I couldn’t see much progress in getting the head out, but Josephine knew almost to the minute of when the baby was coming out. Although I was there for observation and moral support, I was put in charge of Oxytocin and Vitamin K injections and cleaning and swaddling the newborn. I was glad I paid attention to my day in Delivery at Vanderbilt hospital. I will spare the details of the delivery, but you midwives would have been impressed – good looking placenta.

It was an unusually quiet week at Mariine for patients and deliveries. Patients come for all parts to see Josephine with much the same ailments I saw at Samaria. Josephine lives on the compound of the clinic. I now have electricity and plumbing “amenities”, which surprisingly I did not miss much at Samaria except when I needed to charge my computer or write at night. Josephine’s  compound is home to two rather grand avocado trees which I am offered  fruit  from most morning noon and night. It is one of my favorites.  The compound is about a kilometer from the main road and only about 10 minutes by car from Nyeri center. I took a walk to the “shopping mall” about a mile away in the other direction with Josephine’s son, Peter to get the lay of the land. I created quite a stir, but only one boy was brave enough to come up to shake my hand. I continue to startle people with my few words of Kikuyu. Hardly a day goes by when a school age kid is reduced to fits of giggles when I talk to them, and that is when I speak English.

The view up to the clinic from Josephine’s home

I return to Susan’s on the 26th but return to Mariine on December 2nd for a few weeks. There is a professional nursing society meeting for private clinic nurses on the 7th and Josephine will take me to meet and talk with other nurses. There is supposed to be a nurses’ strike starting December 3rd, but it is not clear if the private nurses are being asked to participate. Regardless, Josephine will be open to do deliveries.