Sosoni Clinic, Day 2

September 22, 2012

Today was the last day of clinics.  Our work here is now over, except for an HIV/AIDS support group meeting tomorrow.  It's kind of odd, but kind of a relief at the same time.  It has been good to be here and to serve these people, but at the same time, it is pretty far outside of the comfort zone of our Western life, so there is a certain amount of "bucking up" we do to venture out into this wider world.  Sometimes I stop and think to myself, "I am standing in Africa," and I picture a map of the world and realize how far away I am from my normal life.

In one way, everything here has become normal.  The life we see of people in the villages, the mud huts and dirt floors, women walking and carrying everything imaginable on their heads is what you see all around.  It isn't like there are two worlds side by side (at least not that we see).  We don't travel to all part of Malindi, but the buildings leading into the city and the roads and stores all have a common aspect to life in the villages.  The walkway in the tourist market is mostly broken concrete and rubble, for example.  The hotel here is very comfortable for the standards of Africa, but still primitive by Western standards.  At least for me, I leave my expectations of Western standards behind and adapt to the surroundings that are here. 

In another way, it can never be "normal" and recognition of the poverty is continuous.  In the clinics, we also see children wearing rags for clothes, with shirts barely holding together. Whenever we hand out anything, there is a huge surge of people wanting to get whatever it is, because they have nothing.  Children don’t seem to be starving, but they have subsistence levels of food, no toys, and inadequate health care.  Many people have rotten teeth and toothaches because they have no dental hygiene.  They don’t have enough money to travel 10 miles to Malindi to see a doctor, and they can't afford the medicine if they do get diagnosed.  Several of the Kenyan volunteers are unable to pay for school tuition.  What they are lacking is anywhere from 8000 shillings ($100) for high school fees to 50,000 shillings ($700) for a post-secondary certificate program to help them be employable. An amount that is not a great sacrifice for Americans can change a life here.  How little it would take to improve the quality of life here.

For our final clinic day, I think everyone was tired and ready to come to the end.  Patience seemed a little short at time.  The number of patients seen today was double other days.  Although Amy and Anya were gone, we had three Kenyan health workers with us.  They moved through patients at lightning speed, for several reasons: they didn't have a translation delay, but they also did next to nothing to evaluate the patients beyond the patients' own statements. They didn't listen to lungs or heart, look in ears or throats, etc.  Their treatment was to hand out medicine that seemed to correspond to what the patient said was bothering them.  So medication was flying off the shelf and patients were flying out the door.  For the first time in either trip, triage was falling behind treating the patients.

Towards the end of the clinic, I was grateful to be called away from triaging to photograph the Imani Project volunteers handing out a bag of flour to each child.

 

 

After the distribution of the flour, I skipped out on doing more triage (since Mr. Baya was handing it :-), and I took a walk through Sosoni to photograph the sign for the primary school that was out on the main road.

Sosoni Primary School sign on the road through Sosoni

It was about a half mile out to the road, and I got to see some of the houses in the village in more detail than is possible from the window of the van as we drive along.  Everything is very humble

Buildings in the Village of Sosoni. The white colored wall is smoothed mud that is whitewashed.

Houses in the Village of Sosoni

 

The "toilet" behind someone's house - a sandy and rocky patch with walls for privacy for "short calls" (urination)

While walking through down the road, three people sitting in the shade called our "Welcome!", so went over.  They offered me a seat, and we chatted for a few minutes.  Their English was very good, and they asked if I came from America and where in America.  I told them "Washington" and they said, "Oh, Washington, D.C.!" (as everyone does). I explained about Washington state.  Then they asked about Obama and how he's doing in the election (as everyone does).  I said it was hard to predict.  The woman said everyone in Kenya is praying for Obama.  We talked about the Kenyan presidential election in March.  They thanked me for coming to their village; Sosoni is remote and does not have easy access to medical care.  I love the Kenyan people.  Everyone is friendly and welcoming; it is hard to imagine a more gracious people!

 

My New Kenyan Friends - Kitsao, Julius and Mapenzi

The ride back was almost our last van ride!  We have two more tomorrow to go to the HIV/AIDS support group.  I can't say I'll miss that daily experience any, although I do enjoy watching the countryside from the windows.  If only we could stop and take pictures!  Taking photos from the moving van is not good, but not entirely without success.

Baobob tree, as seen en route



Kadzifitseni Clinic

September 17-18, 2012

The last two days we have been holding clinic in the village of Kadzifitseni  (pronounced cod-zif-fits-enny) which translates to "go and hide" in English. The village is immediately next to the village of Pumwani (pronounced poom-wah-nee), which translates to "relax".  I'm guessing that people on the run would come to Kadzifitseni to hide and when they successfully escaped their pursuers, they stayed and hung out in Pumwani to relax.

Kadzifitseni Primary School

Our start at Kadzifitseni continued a string of forgetfulness that is plaguing us.  For three days in a row, we have travelled somewhere and forgotten something important at the hotel. On orphan day, a suitcase full of gifts was left under a bed, which took 45 minutes round trip to retrieve. On Sunday, Earline and Amy forgot to take a bag of medical supplies to visit Kitsao, a paraplegic orphan Earline sponsors, which took 90 minutes round trip to retrieve.  At Kadzifitseni we forgot a bin with medicines and supplies, which took a two hour round trip to retrieve.  Our dementia is costing us a lot of time.

Fortunately, we had two hours before the clinic started, as we set up and then taught the health kit classes and an AIDS class. We split into four groups again, with Cindy, Anya, Amy, and Earline teaching a class while I played photographer. It is interesting to see the difference from one village to the next.  While people at Karimboni were very attentive and engaged in the instruction, the Kadzifitseni crowd was pretty stoic and seemingly unimpressed.  Even when we took photos and tried to get them to smile, most just stared at the camera.  But their eagerness to get the health kit bags shows that they appreciate having them!

 

 Earline teaching a Health Kit class
 

 

Women who received their Health Kit bags

The medical complaints also are quite different here versus Karimboni.  Karimboni seemed to be dominated by eliphantitis and swollen testicles.  Although we are only a few kilometers from Karimboni, we had only a few reports of the parasitic swelling so common in Karimboni.  On day 1 at Kadzifitseni, the theme of the day was chest pains and "pains around the waist".  Day 2 was dominated by toothaches.  Diane reported that in several cases she had, there was a really rotten tooth that needed to be pulled.  On day 1, many people were anemic and needed iron.  Diane prepared a few iron doses for day 2, and then had no anemia at all. 

Some of the villagers don't have a good sense of what is relevant to their complaint.  The first woman I spoke to on day 2 told us that she fell down while carrying firewood on her head, and it landed on top of her.  Now she has chest pains…10 years after falling down.  The next lady said she fell out of a tree and was stuck in the chest by a large branch.  Now she has chest pains…17 years after falling out of the tree.

Some people have very serious problems, though.  We had several people with jiggers -- sand fleas that burrow into the foot, lay eggs, and then burrow out when they reach the larval stage.  This is a serious problem in many parts of Africa.  Earline and Anya worked for over an hour to get out the worms and then dress the wounds.

 

A girl with many jigger wounds

 

Earline applying gentin violet, an antiseptic

 

Lots of people wanted to be seen, more than we could possibly see, of course.  This trip we have a better story to tell when we have to stop seeing people.  The medicines that the Imani Project has purchased are left with the community health workers, so the villagers will still be seen and get their medicine.

 

People waiting to be seen at the clinic

 

Kenyans do not use family names in the same way that westerners do.  The second name is a tribal name, and so can be many different names.  It is common for children in the same family to have different tribal names.  That would make doing family history work a challenge! Henry has been telling me the translation of the people's names as they come through.  Amani is a common name; it means "amen".  We had two named Furaha, which means "happiness".  Baraka means "blessings" and Zawadi means "gift".  Some other names are a little stranger, such as Changawa, which means "At least".  Kaingu means "a small cloud".  And then there are names that make you wonder why parents choose them.  Baya is a common name, but it means "bad".  One woman was named "Mashaka", which means "problems".  One girl had a last name of Mzungu which is the word for "white person".  "White Person" would be a tough name for an African to have in middle school.

At each village, the Imani Project gives out corn flour to the children, but we have never seen this happen because we are always busy with the clinics in the afternoon.  This time, Francis sent someone to fetch me so I could take pictures.  When I arrived, a large group of children were sitting under a tree, and Francis had them say thank you to the Imani Project in unison (Asante, asante, asante, asante sana!" which is "thank you, thank you, thank you, thank you very much!")  I got a video of them and photos.

 

Children with their corn flour

 

Children with their corn flour 

 

Anya and Earline work on wounds and burns

 

A stooped old man at the clinic

 

The American volunteers after the clinic