Mikinduri Clinics Thoughts

Day 13 – Thursday, February 11, 2010

Our first week of clinics really was a neat week. We’d wake around 630 to a cold shower, run across the street to Father B’s church for breakfast by Bongo-man (yes that’s his name!) and his crew, walk up to the clinic site for 8am, do the clinic all day, pack up around 5, walk back, go up to the ‘Tusker room’ (we coined it this as we drank the local beer Tusker together in this room), get to dinner at Fr B’s around 730, hang out there until retiring for a nightcap in my uncle’s room around ten, and crash between 11 and 1am. The team is a cool dynamic. The main crew that have the most history with these trips (the veterans) were all put on the bottom floor with Uncle Ted, with the least amenities (cold showers, long drop, etc). We were also put on this floor. The cool thing about being on that floor is that this entitled Mom and I to be included in the veteran’s activities. Now, I have no doubt everyone was welcome to come for the night caps, but because we were right there, we were always included. It was cool to hear their stories and recaps for the day as their experience often lended more perspective. This was probably my favorite part of the day, though it’s hard to choose as there are so many highlights throughout.

Additionally on the team are a group of teenagers: 3 girls and 1 boy, 13 – 14 years old. They are the most well behaved, least typical teenagers I have ever met. They’re a joy to hang out with, and I have been quite a bit after dinner and at the clinics. I can’t believe they’re that young! A sobering thought though is that they are older than many of the children who drop out of school to get married here. One of the towns we visited, there was no one in 8^th grade because they all dropped out to get married. As mature as this group is, I can’t imagine them mature enough to care for kids right now. We have a great time though braiding hair and giggling, even though I’m twice their age!

One other thing that’s common to the area is taking multiple wives. Once a man has a million shillings (there’s about 70 shillings to the dollar, so that’s less than $15000), and/or his current wife reaches 40, he will often take a local 13 year old for a second wife (maybe an older woman). The girls have no choice in the matter. Even on the of the Kenyan professionals on our trip, who is a doctor from an urban area, has two wives and children with each wife.

Okay onto the clinics. On Monday, we saw the people from the local village of Mikinduri. I worked in the vision clinic and learned many of the different stations. There’s the triage area to see if they even need glasses, as many people come in and put on a great (but inconsistent) show about being blind, just to get free glasses, as that’s a status symbol here. It’s hilarious….they squint and scrunch up their eyes at the easy ones, but then on harder ones get it occasionally correct. If we are unsure, we have these special glasses called ‘the glasses’ that as soon as we put on them, then can miraculously see! Also in the triage room, we distinguish whether they need distance or reading glasses. Anyone over 40 was sent for reading, and a few of them needed distance as well. The interesting thing about these people is that for distance, they often needed a positive prescription, where for younger people who have problem with distance, they need a negative prescription. To test whether they need positive or negative, we use one of those double sided glasses and say that super annoying phrase ‘is this better or is this better’ and flip them over. Then we sent them off to either distance or reading which use the appropriate glasses strength (there’s a full range of strengths we try) and distance from the chart (distance is about 10 ft, reading is in a chair at arm’s length), to use trial and error to see which is the nicest. Then we send them to the dispensary using our runner, to get them their actual pair of glasses, or if they were faking it, a hat or sunglasses. A few people also got eyedrops, but these were not readily available so we had to be quite stingy. The vision clinic is for all of us lay people, including the teenagers. One day as we were headed to our hotel, a man stopped the teenage boy and said ‘doctor, why wouldn’t you give me glasses’. We thought it was hilarious because he was only 14 and the man really thought he was a doctor!

On Tuesday, we had people bussed in from a local poor town. Apparently last year they moved the clinic to the town, but this year we hired busses. Most of the people had never been in any kind of automobile before, so we got a number of people who didn’t really need anything, but they just wanted to go on the ride. I’d estimate we saw about 500 people each day, between medical, dental, and vision.

On Wednesday, I was supposed to do data entry. Each person received a form that we filled out with their prescription, dental, or medical treatment, in addition to their name and some stats (town, age, etc). This information is then entered into a database I made so the team can be better prepared next year and know which towns people are walking in from (as people were travelling 10+ miles on foot to come to the clinics, those that weren’t bussed in). Anyway the flaw in my plan was that I forgot someone had to enter this data….huh….guess that’s me. J So on Wed morning I went to the medical area as they have an extra room…the isolation room… and used a bed as my desk to enter data. It was really neat being down there as it was much busier and whenever a really neat case came in, someone would grab me. I saw one lady with a giant tumor on her lower lip and chin, to where I have no idea how she’d chew, talk, or even move her jaw. A little boy had a bone sticking out of his foot that doctors kept telling him was a vein because it had absessed. Obviously these patients are referred to the hospital, and should be supported by MCOH (Mikinduri Children of Hope) and Chalice to get them the help they need. As the afternoon rolled around, the nurses realized that the children coming in were very very small for their age. They were in the third percentile for their age group (most people are between 30 and 70, that means they are the smallest of the children of their age), and frankly they could have been lower. The chart only goes to 3%. One little girl was supposedly two years old but she was being carried around and couldn’t have weighed 20lbs. A second girl was 17 and didn’t weigh 80 lbs, and she was over 5 feet. It was so sad! Luckily, someone ran to the store and got whole milk and bananas, and my job for the afternoon was to feed starving children…literally. But since so many people were outside and were so hungry, we had to do it in secret otherwise there would be a stampede. So one by one I’d bring kids in and give them food, sometimes with their mother looking on, not eating as we didn’t have enough for them too. It was heart wrenching! The community that people were being bussed in from on Wednesday was an extremely poor area, and I was shocked at how young the mothers were. Also, they were completely unequipped to be mothers. Apparently they would have the child while they were in the fields working, unaware they’re pregnant, no idea what to do, i.e. to get the baby breathing, and in those first few seconds deprived of oxygen, the child would develop a disability; cerebral palsy was very common., and there were more babies there with a disability than without. So sad! One woman with twins was feeding one of the children with hot water because she thought it would make the baby healthier, meanwhile the other baby who was drinking breast milk was strong.

On Thursday, I worked in vision in the morning, and fed babies/data entry in the afternoon. The teenage boy came to help me enter data and let me tell you, it was so much faster with him! 6 times! I don’t think I’ll get everything entered while I’m here, but whatever I don’t bring home the better. Also that day we saw a few more cases of elephantiasis. There were at least 5 cases that week. My last case of the day I went up to help the vision clinic pack up. A man walked in who I’m nearly sure was drunk. That was hilarious. Everyone around said he was just staring at me, but I really think he was drunk. He walked away with glasses….though they may be the totally wrong prescription. J

Thursday evening there was a massive party with the local translators, after we packed up the clinic of course. Fr B and Ted had some fun random activities planned, lots of speeches, and a roasted goat. I tried it, but that will likely only happen once. With everyone there, we couldn’t waste any of the food, so even if you didn’t like something on your plate (i.e. goat on the bone that was put on your plate much to your polite objections) you still had to eat it. One thing that happened throughout the night too was I got hit on….a lot….by married men (who I guess were on the prowl for number two), boys in university, and even our combie drivers. It was really not funny. One of the married men gave me a nice beaded necklace (he was the chief of police of the town) and I made sure we weren’t engaged by my acceptance, as apparently rejecting a gift is not allowed here. It’s the ultimate insult. We danced the night away and were really amazed how well everyone (but us) danced. It was so much fun!

Summary: A good week of clinics, that was exhausting!