Upon first recognizing just
how overwhelmed we were when taking on the roles of the medical advisors for
the Kenya trip, Andi and I were glad at all the help we received. The pre-camp proved to us both just how generous
Canadians are. We both stared in amazement
at the piles of medications, dressings, toiletries, glasses, safety equipment
and much more, trying to find a way to keep it all organized. I think we ended up with about 20 duffle bags
each weighing 50lbs filled with medical gear.
Special thanks go out to everyone who took the time to gather the
donations, including the donations.
The first hurdle passed, we
finally arrived in Nairobi without losing a single bag! Customs weren’t an issue and we made it all
the way to Shiru with everything. We
knew the priority was to build the ward building, but Andi and I had our minds
elsewhere. First of all, we were making
sure 17 contingent members stayed healthy, and we had our hearts set on helping
out at the clinic. Fate was against us,
as we were all living in very close quarters and a stomach illness passed
through a number of team members-some requiring a small dose of
antibiotics. A few others developed
stuffy noses and cold symptoms, but we all pulled through by helping each
other. We were very proud to see the
group coming together and helping those that were under the weather by bringing
them food and taking on their chores.
While the team began work on
the foundation, AndI and I began going through the mounds and mounds of
medication with the Shiru pharmacist Acquilynne. She and Eluid, the clinic’s manager, were so
overwhelmed by the sheer volume of donations, most of the unpacking was put on
hold, as there was clearly not enough shelf space for any of it. While Eluid took on the job of finding
someone to build new shelving units, Andi and I spent some time getting to know
Scrita, the head nurse at the clinic.
She’s been working there for about 16 years. She basically runs the show. Always smiling, she truly made us welcome,
giving us Keswahili names “Khamede” for Andi and “Nakhuminja” for Jen. She was to become our Shiru mom.
She showed us around the
clinic. Our minds were blown. A triage room, a small makeshift treatment
room with no running water and the door is always wide open so a HIV tests and
Hepatitis and TB tests decide the patient’s fate in fifteen or so minutes. In another building, small rooms for
expectant mothers, family planning and immunizations help the community learn
and grow towards a healthier future. The
Shiru Health Clinic is one of the leading HIV-AIDS prevention clinics in the
country. I truly believe it is because
of the wonderful staff who get to know their patients and help them make better
decisions in life.
The third building is a
maternity ward. They deliver babies
almost every other day. Unfortunately,
the whole time we were in Shiru, we were never at the clinic when one of the
expectant mothers went into labour. The
birthing room is stark and has semblance of sterility. We didn’t touch anything. What an eye-opener. Dora, another nurse, and Scrita both stay in houses on the clinic grounds, so
if someone needs help, they are there 24/7.
The clinic is currently a level 3 out of 6 on the Kenyan Hospital
scale. With our help, the new building
where people will be able to stay on site will help to bring it up to a level 4
facility. When the building is complete
and the clinic can acquire an ultra sound and x-ray machine, they will be able
to employ a physician 24/7. As of now,
nurses and clinicians run the clinic, diagnosing treating and prescribing.
During our stay, Andi and I
took part in 3 separate outreach clinics.
On each outing, members of the contingent went along to help and get
their hands dirty in a different way.
Florence, who is the community relations nurse, and Scrita regularly go
out to outlying villages to see patients who cannot travel all the way to
Shiru. They usually take what little
medication the MOH and government send to them-mainly anti-malarials, generic
painkillers and amoxicillin. They do
referrals and check expectant mothers while immunizing those who need
immunizing. We had no idea what we were
getting into.
The word spread that the
Canadians had arrived and had brought medications. We had to pack the bags based on what the
staff asked for. We had zero experience
with tropical diseases, such as Malaria,Thyphoid, and Dengue, never mind the
more heartwrenching commonalities such as malnutrition and lack of hygiene. We set out on our first outreach at Makuchi
with Ashley to help us with medications.
Driving way off the main
road, through never-ending dropped jaws, as Mzungus were very rarely seen off
the beaten path. We made our way to a
small power-less Salvation army church.
Many children smiled and waved at us as we approached. We set up a treatment area and were
introduced to our interpreters. It
seemed fairly calm, about 30-40 people sat in the pews, as Scrita welcomed
everyone.
The day began slowly and Andi
and I soon realized there was a pattern starting. Many, many people were suffering from upper
respiratory infections-August is their cold and flu season, as it rains at
night and the temperature drops. The
regular treatment is antibiotics and painkillers. We were told to give each of these patients
Amoxicillin and Ibuprofen. Andi and I
looked to each other and tentatively moved through patient after patient,
realizing we were taking much too much time with each patient. We were checking pulses, blood pressures,
temperatures, and blood sugars, all while trying desperately to assimilate to
the rural Kenyan treatment style, all while retaining as much of our own style
as possible.
The interpreters were
great. They became used to our questions
and were able to explain our findings very well by the end. That was the easy part. As the day progressed we began to realize our
impact. Hundreds of people flooded to
the church. Andi and I tried to keep
up. Scrita was checking pregnant
patients on a makeshift bed of two side-by-side benches. Florence spent the day immunizing. The mood of the day began to change as Ashley
started warning us that we were running out of medications-she was running back
and forth and was the saving grace of the day.
Without her, the number of patients we saw would have been cut in half.
Along with the dwindling
supplies, the number of patients was increasing and it began to rain. Our lunch consisted of sodas and cookies and
when we returned to treating patients the church was so dark we had to work by
flashlight. Any light coming in through
the few windows was blocked by the sheer volume of people pushing forward,
surrounding us to be seen. It was almost
impossible to work, until finally Scrita and Florence told everyone we were
done for the day.
Mentally and physically exhausted,
we were smiling on the inside and out.
Ashley, Andi and myself directly helped almost 200 people. From respiratory infections, to very
seriously infected wounds, from long term illnesses, to new concerns like
diabetes or high blood pressure. We saw
it all. People with Malaria and Chiggers
showed us how important our Malarone and hygiene were while traveling through
the country. We left the church feeling
different. Alive. Our jaws were dropped this time, but we
smiled and yelled “Jambo” back to all the waving kids.
Our second clinic was only a
couple days later. They had not given
the village advance notice of this outreach like they were able to with the
first clinic; however, to our surprise, there were still many people waiting
outside as we pulled up to the church.
We were in the village of Cheptulu for this clinic, in a church on the
main road through Shiru. Due to the
volume of patients at the first outreach clinic we decided to take 3 contingent
members along with us to help; Kiki, Post and Nash (Kristin, Eric and Michael
respectively). At the last minute, Kevin
decided he wanted to tag along as well for some photo ops as well as lend a
hand where needed.
The day started out much
slower than the first, with only one significant glitch; there was only one
interpreter. With Jenn on her way
treating patients using Scrita’s cousin as her interpreter, Kevin went outside
to the queue of patients and asked if anyone could speak English well and would
care to help. A man named Solomon came
forward and offered his assistance.
After a short introduction and treating Solomon first to ensure that he
was seen, we began to see other patients.
Jenn and I saw more of the same issues we had at the previous
clinic. The pace of the day picked up
quickly and while it wasn’t as busy as the first outreach, everyone still have
a job to do. Jenn and I were seeing and
treating patients while Scrita, Beatrice (another nurse from Shiru) and
Florence dealt with expectant mothers and child wellness. Kiki, Post and Nash ran for medications as we
needed them (sometimes even listening in to our treatment so as to have them
ready ahead of time-they did a great job).
They even assisted with blood pressures and pulse checks when
needed. Kevin had double duty; official
photographer as well as the responsibility of registering every patient seen at
the outreach that day.
I had a chance to speak to
Solomon during our ‘biscuit and soda’ lunch and learned that he had spent much
of his 50+ years working in hospitals or hotels. Having dealt with many Canadians in these
past positions, he had nothing but flattering things to say about all of the
Canadians he had encountered and expressed his thanks and appreciation for our
help in the community. Later in the day,
we had the pleasure of meeting a very proud 96 year old Kenyan Scout who
offered a salute and a handshake to any of us that he met. He wore his scout badge proudly on his lapel.
The day went by fairly
smoothly and without incident. Assessing
and treating 196 patients between Jenn and I alone. Kiki, Post, and Nash were busy grabbing
medications for not only Jenn and me, but also for Scrita, Florence and
Beatrice as well. As the day was coming
to an end I noticed that Solomon was no longer in the church. Worried that he had slipped out quietly, I ran
to the door to catch him, and thankfully did.
I called his name and he came running back to meet me, filled with
apologies for leaving without word. We
spoke briefly as I thanked him for his kindness and selflessness in staying to
help and sacrificing his entire day for the sake of us and his neighbours. I pinned a Canadian flag on his lapel; he was
so appreciative for the gift and for us coming to help. We said good bye and he walked away quietly,
having never asked for anything in return for his assistance. So many could learn from a man like him.
As I went back into the
church to help finish up, Jenn was still with the same patient. I could tell from her face when she looked up
at me that it was a significant illness.
She later explained that the woman had stepped on a nail, having it tear
through her foot leaving a serious open and infected wound that the woman had
not yet had treated. Another situation
that reminded us of how different the living conditions are here in Kenya. We finished clearing up the clinic and said
good bye to the people of the village that stayed around to see us off,
including the 96 year old scout. With
another salute and handshake we departed.
There were a number of days between
the second and third clinics, which gave the two of us the time we needed to
organize the donated medications and supplies in the stock room on the newly
built shelves. This took quite some
time, but in the end all the shelves and cupboards in the room were full and
organized! During this time we also did
some follow up with some of the patients we had referred to Shiru for
eyeglasses. Over the entire time spent
in Shiru, we fit almost two dozen people with glasses-mostly for reading.
It was nothing short of amazing to witness what Jenn and I referred to
as the “Eureka moment”. This was the
moment when, after trying a number of pairs of glasses without any success, all
the frustration and disappointment melts away from their faces and is replaced
with a smile and excitement as they begin to read what the couldn’t only
moments before…Eureka!
Our final clinic was in
another church; the smallest of the three.
Although the church was not far from the Shiru Health Center, it was a
fair distance off the main highway in a small village. We had a different group with us this
time. Scrita was busy today, so we had
Florence, Millie and Victoria with us from the clinic and Jamie, Hannes,
Caitlind and Michael (one of the Kenyan Rovers). As the ladies from the clinic arranged for
people to wait outside (which proved to be the better way) and got their stuff
together for the clinic, Jamie, Hannes and Caitlind did a great job of
organizing and arranging the medications to make things easier as the day got busier. They also helped us move benches and chairs
to create a make-shift clinic.
Interpreters were difficult to find that day, so we were immediately
thankful to have taken Michael along. He
sat beside Jenn and spent the day interpreting for every patient she saw. We found one of the local health community
workers to help interpret for me. It was
evident that the communication barrier was still significant, but we learned how
to work with each other and made it work well.
Even though Jenn and I found communicating difficult at times, we will
be forever grateful to those who took the time and patience to help us by
interpreting.
The day was going along as we
had expected by this point. Assessing,
diagnosing, treating and prescribing patients as we had in the previous two
clinics. The day was hot and while we
sat under the quasi skylight for our biscuit and soda lunch, we were especially
aware of it. Florence, Mille and Victoria
were very polite in telling us that we needed to increase our pace to clear the
queue of those waiting to be treated.
This didn’t come as a surprise to us, as we knew already that we were
much slower than our Kenyan counterparts.
After lunch we tried very
diligently to pick up our pace as the number of patients waiting outside
increased. During our time with the
outreach clinics there were countless times when Jenn and I would refer to one
another for a second opinion or even just for confirmation. Often calling each other over to have a look
at the patient in question. During the
afternoon, while I was just finishing up with my own patient, Jenn called me
over. I could tell immediately it wasn’t
a second opinion or confirmation type of thing…it was different. With the number of people around us, I couldn’t
see her patient until I was done with mine and walked over to her. Neither of us were prepared for what we
saw. A woman holding her young baby in
her arms sat in Jenn’s patient chair.
Words alone cannot accurately describe the condition of this poor baby
girl. Extreme malnutrition, open wounds
over her entire body and face, swollen and edematous extremities, her left eye
swollen shut and her left ear completely enveloped with infection. To say the child was next to death was a
troubling but true fact. Holding back tears,
we tried to explain to the woman that if she did not take her child to the
hospital right now that her child would most likely die. She had already been referred to the hospital
in Kapsebet to get medical care for the child, but didn’t go due to lack of
funds. Jenn asked the woman if she would
go right now if we gave her the money; the woman agreed. Jamie handed over the 200KSh that likely
saved this child’s life. The money was
given to one of the village elders to drive the woman and her child to the
hospital. Immediately after she left,
was an intensely surreal moment and more than a few tears shed for the
condition and fate of that baby girl.
The rest of the clinic was quite somber and our minds were elsewhere,
but we pushed on trying to treat as many patients as we could in the time we
had left. We did our very best, but at
the end of the clinic there were still patients pushing into the church, waving
their medical report books in our faces trying desperately to get us to treat
them. Sadly, we could not help them
all. We packed up the clinic supplies
and carried the bags out past the people, who were walking away slowly and
somewhat disappointed, but still they had smiles for us and waived their good
byes as we drove away.
We learned and experienced a
lot in our time at the Shiru Health Clinic and even more while at the outreach
clinics. We had happy moments and sad
moments, but at the end of the day we consider ourselves honoured to have
gotten to know the amazing, wonderful and happy people of Kenya and the culture
that came with them. The people we
encountered and our experience working, treating and interacting with them have
changed our lives for the better and we will never forget them.
by Jenn and Andi
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