Week 4

On Sunday Le, Tammy and I decided to go for an adventure with George (Alice the Anesthesitis’s “brother”. Actually I just realized I haven’t talked about Alice yet so allow me this tangent to tell you a little about her. She is fantastic and I love her!! Alice is a Clinical Officer, Kenya’s equivalent to a PA, who did further training to perform anesthesia and has been working at St. Josephs for 5 years and Homa bay district hospital for 1 year, she is extremely busy. She lives next to our house in the hospital compound and was one of the first people to welcome us when we first arrived at the house.She has been extremely helpful both at the hospital and with cultural issues here in country. Last week she invited us over for a glass of wine and her favorite soap opera, which she is obsessed with! While we enjoyed a wonderfully cold glass of South African white wine, we met her “brother” George, cousin veronica and actual brother Jeffrey (who also works at the hospital in maternity and is amazing with mothers in labor, fun to work with and in general another one of my favorite people) George and Alice talked about some places they thought we might enjoy visiting that are nearby. Thim leech, Ruma national park and Gogo falls and we made arrangements to go with George the following Sunday to visit one or two. In short Alice is one of my favorite people here and meeting/spending time with her has been another highlight of the trip). Now to continue with my story….

So George helped us arrange to rent a matatu for the day and accompanied us on a trip to Kisii which is famous for its soap stone carvings and then on to Ruma National park, which is home to elephants, giraffe’s and many other animals. The trip was, which I’ve grown accustom to, difficult from the beginning. The drivers of the matatu decided that the price of driving all the way to Kisii and then to Roma (which are in opposite directions) was too far for the previously agreed upon price of 8,000ksh (94$) so we had to negotiate a new deal which included paying for the petrol. After some haggaling we agreed upon 11,500ksh (135$) for the whole day rental of the matatu. We spent 1hr ½ in Kisii looking through the many shops and buying up beautiful souvenir bowls, chess sets and vases. After our shopping spree we piled back into the matatu and headed to Ruma. We stopped in a small town to pick up some lunch, well the drivers picked up lunch we had packed snacks. Lunch for the drivers consisted of a loaf of bread and a pouch of milk (no cartons here). We shared our peanut butter Cliff bar with the drivers. It was pretty amusing to watch them take such a small bite at first and then gobble up the rest of it. As we pulled into town we noticed a long line of people in the street, as we got closer we saw the line was made up of children in uniforms all marching together. George explained to us the scouts were having a parade. Girls scouts, Boy scouts, Eagle scouts, Brownies there must have been 80-100 kids marching down the street. Then George told us he was a scout and we compared scouts in the states to the traditions of scouts here in Kenya.

The drive to Ruma was filled with sweeping green hillsides dotted with farms, tin and grass hut roofs and some unbelievable views of the entire valley. After 2hrs of driving we finally reached our destination. Unfortunately we had been told the entrance fee was 200ksh, turns out that is the price for Kenya residents, the non-resident price is $20 USD!! We offered to pay the student price of 10$USD but apparently that only applies to students under the age of 23. And I realize one of Kenya’s primary draws for tourists is their parks and wildlife, so I understand the price. Unfortunately we are here as volunteers to help people in the area and I think with as many missionaries and volunteers as they get, it would be reasonable to also have a lower price for people who are here to work, not here on vacation with a ton of money to spend. So the fee would have made our trip a grand total of 65$ just for Ruma… After much deliberation and many failed attempts to negotiate with the park official, we decided it was just too expensive and turned around.

The rest of the week at St. Joe’s was pretty normal filled with the mundane, spiked with a few exhilarating, yet sad incidents. I rounded on the Medical ward with Dr. Megori, who is a great teacher and it was interesting to compare treatment plans, which most of the time were very similar. I got to see an AIDS patient with a classic manifestation of Kaposi Sarcoma and was shocked to see her CD4 count was literally 1! I had a few patients die, but unfortunately they were immunosuppressed and circling the drain, there was nothing more anyone could have done. Tammy and Alice had a very tough case this week, a small child of around 2yrs was brought in with severe burns over the face and upper extremities, after a successful resuscitation and careful management, she later died due to resources. Unfortunately the hospital doesn’t have an ICU for patients that need that high a level of care. What worse is that even if they did the child’s family doesn’t have the money to pay for it. One of the saddest things I’ve seen is the grandmother and mother of the child paced and wailed outside the hospital gates for 2 days mourning the loss of the child, but also begging for money to pay the hospital debt to release the body for a burial in the family plot.

On Wednesday we drove up to Homa Bay district hospital, where we toured the facility and participated in rounds. The district hospital is a government run hospital and the difference between it and St. Joe's is striking. The district hospital is larger, with more patients and worse pathology than St. Joe's. They are severely understaffed ( 2 nurses for 26 patients in the surgical ward I rounded on) and the drug supply is unpredictable. It is a teaching hospital though so the Doktari I rounded with (Dr. Elisa) had 12 clinical officer student with him, so he was an excellent teacher! After rounds we met with the principle and administrator of the CO school next to the hospital. After our tour of the school we drove down to Lake Victoria and had lunch at a hotel right on the lake!

We finished off the week in Bware where we were scheduled to meet with the BBEKAS group and BUCHWA. We arrived at Bware primary school as the venue for the meeting; however as with just about every meeting in Kenya there is the 2 hour window of when the meeting actually takes place. So we played with the children until the other headmasters arrived. Tammy organized a football game and Heather and I walked around talking with the kids. We met a teacher conducting a small group of children singing in the corner of the soccer field and the children sang the most beautiful little song for us. In speaking with the teacher we learned the group was actually practicing for a competition next week. It turns out they had already won 2 other competitions and were scheduled to compete at the provincial level, if they win they will go onto the national competition and winning there means the opportunity to sing for the President of Kenya!

Later we met with the headmasters of the primary schools and presented them with a form to track the health of their students over time. We also outlined implementation time line and the logistics of completing each step.We also met with the BUCHWA group and gave a presentation on female cancers, diabetes, hypertension and stroke. As well as conducted a workshop on taking blood pressures. We also toured the Bware dispensary and inventoried the items we brought as a donation.

Only 12 days left, 4 days at St. Joseph’s, 1 day in Bware, 1 day of travel to Mombasa, 4 days in Mombasa! 1 day of travel back to Nairobi and on Friday June 24^th we leave Kenya.