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!

From Danelle Besaw (on medical team)

Hello from the medical team. We had a nutzo week on our first try. Starting early in the morning, we’d be the last to finish with the last doctor finishing at 7 at night, but what joys there were hidden inside. We saw everything from little babies to an 80 year old man who complained about sore knees from walking miles a day and climbing trees. We had a few emergencies that came in that thankfully turned out for the better. They are now happily in the Meru hospital, being looked after. We’d see many very disabled individuals who never had wheelchairs and were carried around all day. Thanks to Ed and his skills, many of them walked away with crutches. There was even a four year old who got a tiny wheel chair.

There were many interesting cases. People get malaria like we get colds. Many of the mothers were quite young. For the most part, we didn’t see very undernourished children, except for the third day when a bus came in from a far off community. Nearly every child had arms like twigs. There was Libby and Maribeth hiding in a closet corner secretly handing out food to the children, afraid that a mob of hungry people would swarm them. Unfortunately they weren’t so successful on Thursday when Libby and Jordan handed out milk towards the end of the day, right when the gates were opened to swarms of people. It was bedlam, but we’re happy to report they’re still alive and no bruises. On the first day, Greg McKenna took on quite the role in the clinic. First he switched watches with one of the nurses, but the dainty pink plastic didn’t quite match his outfit. Then he was found a few minutes later, holding a pair of newborn twins: Ivy and Dorothy. (Awww). Another exciting story, one of the babies in the maternity ward where the clinics were being held, was named after our very own Kathy Mutch, because she was seen the day before passing out blankets and hats.

At one point, I asked my translator, ‘oh my gosh, they’re fighting over there’, but she laughingly responded that they were simply having a conversation. ‘That’s just how we talk’, she said. The sheer volume of people we helped was overwhelming. We thought, what difference can we make when we’re only here one week, but with the amazing referral process, allowing people to get help while we’re gone, supported by the MCOH, and the amount of people we saw, it really is effective, long-term impact. Many people would try to find me after being seen. They’d smile and shake my hand, thanking me for help. Well that’s all from Mikinduri. We’re on the move again. Miss you all!

Here's a blog form the dental team:

I found it neat to work out of a tent versus being inside a building the last few years. The local dentists also found it easier because there was better airflow and lighting. We made great use of the dental chairs donated by the provincial (local) government. We used four of the chairs for the dental clinic and passed 3 of them to the medical clinic for their use. It’s an interesting dynamic to be in the middle of the camp where my patients can not only be seen, but heard all over. As before, the patients are in dire need of treatment and you’re only alleviating a bit of the pain, and could easily come back for a number of appointments. Our last case was to remove baby teeth out of a malnourished child with downs-syndrome, aged six and looked no bigger than the age of three. It was heart wrenching, but seeing the condition of his medical and dental health, it warmed my heart. Statistically we’ve taken out 530 teeth in four days thanks to the help of Mercy and George (local Kenyan dentists).

Faith, who’s mother runs St Anne’s orphanage that supports 21 infants, worked as my chair-side assistant. Her compassion put the patients at ease, and she was a great communicator. She pursuing an opportunity to study nursing in Canada, but we couldn’t quite convince her to become a dentist. Florine, a Mikinduri local volunteer, did all the oral hygiene instruction, post op instruction, handling paperwork, and patient movement. When walking home at night, I’ve never before had kids begging me for toothbrushes.

Monday morning in Mikinduri, we headed up to the clinic. While walking through the village, we felt a bit like a celebrity or rock star, as kids were pointing, laughing, and saying ‘muzungo’ (white person). The people were all very friendly and quite excited to come up and talk to us. We then walked up the dirt lane to get to the clinic and people were already waiting to get in. There were 3 main clinics set up, medical, vision, and dental, and an area set up for registration where they also learn about hygiene. We got the vision clinic situated and were open for business. I was working at the reading station the first day helping determine which reading glasses people needed. It was amazing to see their faces light up when you got the right pair and they could read their bible again. We were all a bit nervous to start the day, as you felt the weight of finding the correct prescription but that was soon assuaged. There was one gentleman, (as George relates), that was a preacher and he had memorized the bible since he could no longer read it. When he was fit for the correct glasses, his face lit up like a school boy when he realized he could read again.

The interpreters are the key to vision clinic; they are local Kenyans who have amazing English. Without them, it would be impossible to perform the duties. Plus, they’ve been super helpful in learning Swahili. Margaret and Evans taught us part of the local slang. ‘Mougo’ is followed by ‘Mougo Muno’ (Hi…hello). Also ‘Sasa’ (how are you) is followed by ‘fit’ (fine). It has really helping with the kids and walking up the street.

The vision and dental teams got to leave at the appointed time, but the medical team was working into the night. When we were headed back to the hotel we were praying there would be running water as only the ground floor had (cold cold) water when we left in the morning. Then most of us headed to the ‘tusker room’. It’s a room on the third floor that we can all meet and relax with the local beer ‘Tusker’. It’s becoming quite a highlight for developing bonds within our group. After a late dinner, and team meeting to discuss how we can improve. The teenagers with us have become addicted to the local Fanta soda flavors: orange, pineapple, and pear. Also, one thing I didn’t expect, we are all becoming one big family to fill the void missing our family and friends have left. We hope you all know how much we miss you!

Note: attached pictures (courtesy of Karen McKenna are Greg Butler with the children on Saturday and a few of the team (Jewell Family, Greg Butler, Ryann Jinks, George Likely, Catherine Sue, and Joann Boere) in the town of Mikinduri on the way back from the clinic.

Preparations

Day 9 – Sunday, February 07, 2010

This morning we had church at 7am (gasp! So early!) at Fr Bernard’s St. Massimo’s Church. It was a special service just for us, as the regular mass at 11am will include confirmation for 100 kids from the nearby area. The church was a massive stone building that could hold a few hundred people. It was sparsely decorated on the inside but was clearly a huge luxury for the town. On the way to mass, we ran into a woman who was much to skinny, and clearly a little touched in the head. She was dancing and singing with a metallic blue garland and she followed us into the church. The alter boy, a local seminarian, chased her out with a stick…literally. I guess she had been a nuisance before. That was my first shocked moment. I have never seen anyone chased out of church before, but I’m sure they had their reasons.

After a lovely mass followed by a hearty breakfast, (thank you Bongoman – yea…that’s our chef’s name!), we got back to sorting. So far the weather had been cool (80’s) with the occasional hot day. Today was hot! It was easily 100 degrees and not yet 11am. We had a nice lunch, a break in the afternoon as we worked so quickly, then headed up to the clinics to get set up and be oriented. After finding out how the vision clinic would run, I am a bit trepidatious as everyone else was trained previously in Canada (while I was in Arizona), but quite excited to see what this is all about. Today was a day for learning words (note: phonetic spelling): ‘Mouga’ (hello) is followed by ‘Mouga Moona’ (hello) for some local slang. Also, ‘Sasa’ (how are you) is followed by ‘fit’ (fine) or ‘nzuri’ (fine but also means pretty). You have to be careful though as just ‘Sa’ means what time is it. The local children all stand outside the hotel so when we stand on the second floor, we can converse with them. Caroline is there to help us with the English; she’s a local child, but a real asset to have nearby. We had some socializing time before dinner to relax and I tried a local lager. Then we went to dinner and had a great beef stew over spaghetti (not curry!) with some local wine called ‘mass wine’ that tasted just like a white port, not what mass wine typically tastes like. We had a bit more time for socializing, then it was off to bed. I have to say it was quite odd to walk down the street and have every face staring at you. Maybe this is what it is like to be famous, and if so, I don’t want it! They are all friendly, and often smile back, but it is a different feeling.

Summary: While not used to all of the attention when walking around the town, today was a day for setting up the clinics.

The first day in Kenya that my heart was touched

Day 8 – Saturday, February 06, 2010

I was awoken by my uncle with a giant pounding on the door, about 10 minutes before my alarm was set to go off. (Random, but should be documented). We trudged through the rain to breakfast and enjoyed a nice English breakfast. We saw an amazing view of the jungle with lush green everywhere! Apparently 9 elephants (including four babies) had walked through the day before but we just missed them. We jumped on the bus, for a 3 hour van ride, to a town called Meru, and had a lovely lunch (curry). In order to get to the town, we passed the equator. Cool! We also had 10 minutes to run to the internet and a walmart-like store.

Then we headed for a 20 minute drive to Mikinduri and on the way stopped at the dining hall that Mikinduri Children of Hope sponsors where the kids go once a week for a meal and education on nutrition or job training. We were going to serve a meal to them. Well that was the plan, but unfortunately we were about 30 minutes late. We pulled up to 100 children and adults cheering, singing and dancing on the side of the road. We got out and were enveloped by these adorable, loving children, who had an endless supply of hugs and were eager to hold our hands, even though we were complete strangers. They escorted us back to the dining hall, which was about a ½ mile walk from the road. It was incredible. All of the kids were staring up at you and as soon as you smiled at one, they’d shyly look away but give a great big grin back as soon as they’d raise their head. I walked with two adorable girls called Ruth and Margaret, who were quite happy to pronounce ‘My name is ___’, in very clear English. The rest of what they said was a bit hard to understand, but their English was way better than any other language I can speak. All of the children were a sea of dark skin, short, shaved hair, and purple uniforms. Shorts for the boys and dresses for the girls. It was nice to have this distinction, because with the short hair, it was a bit hard to tell boys from girls, especially because they were all so beautiful! Every child except Ruth had dark brown eyes, but Ruth’s were a captivating hazel that just made her stand out from the crowd. They gave a short presentation in which a girl named Caroline, with amazing English, explained to us that they were happy to have us there and they would do a dance for us. The song and dance were great! After a prayer from the local priest and a few speeches by local dignitaries, we got to serving rice, stew, and papaya. First for the kids, then for their parents. Then we had the opportunity to play with the kids: Macarena, chicken dance, hokey-pokey….all the classics! Upon leaving it was amazing to see how touched we were by these children and their parents in such a short time. I really couldn’t have expected it, nor am I putting it well in words.

Then we travelled to Mikinduri. This is the site of our first clinic and this town is the whole reason the foundation was set up 10 years ago. The town was remarkably different from every other town we had visited. It was very sparse and poor. We got to stay at the brand new 5 star hotel in Mikinduri. This is a bit of a joke as the 5 star is only a comparison to the other hotel in town. Apparently last year, they were run out of the other hotel by the number of beetles and cockroaches. Nonetheless, this is the experience we were expecting, so really we were spoiled the last few days by our previous hotels. The mattress was brand new, with the plastic still on, and felt like a combination of straw and dirt. Let’s say, it is very firm. J The pillow (yes only one) that mom and I shared on our double bed had the airplane quality with a scary cover, that I just don’t want to think about now. We added a few plastic chairs in the room so we could unpack our suitcase (as much as you can on two plastic chairs). No I’m not done. The bathroom was about 3 ft by 3 ft with the toilet tank mounted 7 ft up on the wall, and a pipe that ran to a hole in the floor. Odd….that was directly under the shower head as well. “Holy crap”, I realized, this is a ‘long-drop’ toilet inside the shower! It’s a one stop shop! Additionally the locks on the doors were quite indescribable, but I’ll try. It involved (from the outside) putting your arm through a small slot in the door to maneuver a deadbolt into the hole on the inside, then attaching a lock. All of this is unseen, (covered by a flap) for security and just to make it as hard as possible! All of these hardships were really only seen on the ground floor, which is meant for the people who have been on many trips before, and those lucky enough to be related to the organizer. All of the other floors have a toilet, a nice mattress, pillow, and a key lock. There were a few other issues with my room including a leaky ceiling in one spot, no electricity for my computer (gasp!) and a running toilet (yes that is somehow possible with only a hole in the floor), but I don’t want to go into that. Considering the local economy and housing, I feel quite fortunate and am so blessed to be able to complain.

We went to the church and had a lovely dinner (yes, an amazing curry!). Then sorted the glasses into strengths, sorted the pills, and did general preparations for the clinic on Monday. It was an exhausting day and I was quite happy to hit the plastic covered mattress with the mosquito net covering. Another amazing day, where we are getting a taste of what is to come.

Summary: An amazing welcome (Caribou!) by some beautiful (nzuri) children.

A Forest in Kenya??

Day 7 – Friday, February 05, 2010

We started our day only a few hours after the previous one ended. It was great to sleep under the mosquito net – felt like a princess covering like in the good old days of England. I had a piping hot shower and headed to breakfast, unsure of what would be available. There were really nice fruits, including star fruit, bananas, watermelon, and pineapple, British sausages, hard boiled eggs, and a grain I was brave enough to try called Ugi that was a nice experience….once. The grain was a brown color that had the consistency of cream of wheat. It did not taste like that at all. The after-taste was pleasant, but the initial taste was somewhat bland and an odd texture.

After lunch we loaded the vans with the giant bags and headed on a few errands before heading out of town. The driving was crazy! Everyone seemed to know the rules, but it really just seemed like some kind of ordered chaos. There were no street signs, or distance markers, but everyone seemed to know where they were. The houses were beautiful behind large gates with armed guards. Later on as we got out of the city, you could see the change in affluence. People were walking everywhere, including children wandering on their own down the road. We came across a number of school students once out in the country who were too excited to wave and say hello! Apparently we’re quite a freakshow to the kids – a van full of white faces. The crazy part was, everything was green and lush! We passed by the largest pineapple farm in Kenya and a number of other farms including tea leaves farms. There were people along the road carrying large loads, goats and cows roaming everywhere, and the neatest most colorful shops. After a bit of a bumpy drive, we came to this shockingly small dirt road with thousands of bumps. It was probably 10 miles long, which took an agonizing 30+ minutes!

Once we arrived at Castle Forest Lodge, which I thought was supposed to be an ironic name, I realized it wasn’t. The rooms were actually bungalos and a main large lodge. Each lodge was for two people with single beds and the bathroom had a shower that was a spout and a drain in the corner of the room. No curtain or separation from the bathroom at all! It was beautiful with a nice waterfall nearby, great food as we settled in for the calm before the storm. In fact, it did rain that night! Lunch and dinner were both curry based and we had the afternoon to relax and explore, and a nice team meeting in the evening.

Books finished: 5

Summary: Kenya is so green and the people are so nice!