Today was my first real day of my trip and it will probably stand out as being the most memorable. Let’s start with last night/this morning-I got into Nairobi at about 8pm-we were a little late because our hulking KLM jet (right as it was landing) had to do an emergency climb because there was a plane still on the runway! After that scare, we landed without problems and I nervously figured out how to get the Visa and was relieved to see the cab driver the mission workers trusted waiting for me. Just before leaving I read the state dept warnings about Nairobi and didn’t want to be stuck there at night. We drove to the hostel I had made reservations at and he told me he would be back at 5am to pick me up for my 7:30 flight. I thought that was a bit harsh considering the airport was 20 minutes away, however I learned that the main road that the airport was on was a nightmare traffic-wise at 6am, so I barely slept last night for 2 reasons- 1) I was in a strange place and didn’t want to miss my alarm 2) I had to sleep under mosquito nets (which I am under right now). Mosquito nets are a weird thing-they give you the feeling of being back in the womb and are definitely not for the claustrophobic!
I am also shooting a video documentary of everything, as well, so I shot some video and tried to sleep. I barely slept and was up soon enough to catch a plane. On the way to the airport at 5:15 AM, we hit a police barricade and the taxi driver told me to “sit still and don’t say ANYTHING!”. We were pulled off the road the driver got out of the car and opened the trunk to my waiting bags (which I thought the police was going to steal), but instead after a few minutes, the driver got back in the car and drove away. “They were looking for any small mistake in my registration or my car-if there was one I would have to bribe them or get jailed.” Later in the day, I read a story in the newspaper about a man getting carjacked by a cop, after he refused to give up his car, he was bitten by the officer and now is being treated for HIV as the officer was positive.
After this, I arrived at the airport. While waiting I met another mission worker while waiting for my plane in the Nairobi airport. His name was Michael and he on his way to northern Kenya to set up the region's first drug addiction program. He said there was a heavy amount of chemical sniffing and crack usage which made me reminisce about Memphis.
Finally, I hopped the "jet" to Kisumu airport, which is essentially a paved strip in a field of grass. If pictures were allowed, I could show you the air control tower/shack. A salvation army brass band was playing for a dignitary that was arriving.
I met there Nan Hardison, she is the better half of the Doctor who helps run the Maseno Angelican Hospital where I am spending this month. As we rode in her jeep from Kisumu to Maseno, we discussed the political climate (in the newspaper that day was a man that was jailed for 3 months for giving the middle finger) and this strange double standard of Kenya. You see, the region is extremely conservative and mostly Christian, yet premarital sex, prostitution and many of the things Christians would consider sinful are permitted here.
Everything around me resembled the overhead disaster footage you see on CNN after a tornado rips through the Midwest-destroyed buildings, garbage everywhere, people walking all over the road or on bikes. When we arrived in Maseno it was even more remote and impoverished. What struck me as odd was despite how poor the living conditions were, people were dressed quite well, usually in suits, jackets, nice slacks-hardly clothing suited for these weather conditions.
The town in nestled in the mountains about a 20 minute drive from Lake Victoria. There is a University in this town, but it is nothing like the universities in any US city. As we arrived at the hospital I was aghast. It wasn’t a hospital but rather just a series of small open buildings with hospital beds not unlike those you see in world war 2 movies with a web of mosquito netting around them. Chickens, Cows, and even packs of monkeys roamed the grounds outside the hospital- I knew I was truly on the fringe.
It was after arriving here I met Helen, a 4th year medical student from UC Davis and David, an Ear, Nose, and Throat Nurse Practitioner . I was taken to the cabin where the 3 of us are living and shown my room. My room is approximately 11x11 feet and those feet are inhabited solely by 2 sets of bunk beds and 1 chair. There is a small amount of floor between the 2 sets of bunk beds but that’s it. I discarded my things and ate breakfast - a brick of “wheatabix” which is a coarse, glued together brick of wheat and room temp milk (which tasted differently as you can imagine). I was introduced to Emma, who is the maid/cook for us-a very sweet African woman.
Afterwards I was taken on a tour of the wards and introduced to all the patients - the sickest of which being a small 4 year old girl who didn’t weigh more than 40 or so pounds who had an empyema (lung full of pus) which had already been tapped 3 times for 1.8L of pus. She was breathing hard and fast and was not improving. Later that day she was transferred to the government hospital to have a chest tube put in as she developed a pneumothroax (collapsed lung). It was amazing to me to see patients who would be in an ICU in the US being in these ward beds-one patient had Toxic Epidermal Necrolysis (TEN) and his skin was sloughing off, rendering himself essentially a burn victim from an allergic reaction. He needed ICU care and to be out of an environment where flies were coating his rotting flesh and insect borne disease could easily kill him, but this was all he had.
Rounds were less medical and more of a statement on the health care system of Kenya-while anyone could go to a govt. hospital-those without the means to pay would be “rescheduled” endlessly until they got better or died. To my surprise, the hospital I am at is actually a for profit, private hospital-with patients expected to pay before they can go home (many patients were well, but waiting for family to “bail them out of the hospital”).
After my tour, as expected, I learned that the typical resources we had at our disposal-CT/MRI/ lab tests like PT/INR, complete metabolic panel were just not going to happen here. It seems like a system of futility at first glance-but you end up trying to save the people that can be saved. Every patient here gets a smear for malaria because it’s so common and most are tested for HIV. There is even a clinic for those who are HIV infected (a “comprehensive care clinic” reminiscent of the “Adult special care” clinic in Memphis) which serves to keep the HIV patients somewhat separated from a fearful general population which is slowly becoming more and more infected. It is a social quarantine.
I ended up talking to Helen a good deal that day about faith and what made her do this-she is a Chinese born again Christian and explained to me that her being Christian essentially made her family split from her. Her mother grew up under the “religion” of chairman Mao, who was worshipped like a God among men and was weary of religion. She later told me that through faith and prayer, her family began to come around and heal the wounds. She is recently married and her husband was up here the week before, but now she will be without him for the next 2 weeks or so. She is using this experience as a watermark if she wants to end up doing rural global medicine-and she plans to pursue family practice/OB/GYN for residency (a field nearly impossible in the US because of malpractice costs).
Eventually, we all went to Maseno University to use their cyber café and email our friends and families and let them know we made it alive (which despite my serious jet lag and urge to pass out on the ground by the chickens, was my top priority). After sending out some emails and heading back to the hospital, I realized as I went to look up a drug side effects that my PDA was GONE. My brand new Ipod touch was gone. I scrambled all over the grounds and back to the university computer lab but it could not be found. I think I was pickpocketed as I was in the lab. It was then my fears started coming to life-I am the ONLY young white male here-my Chinese medical student guide told me the words kids were shouting at me meant “white person” in Swahili. Was I more than just a novelty, but a target?
As I spent hours combing the hospital and university grounds, retracing my steps, my fear worsened. There is no lost and found as you can imagine-and I had all my medical programs, my currency calculator, contacts, and even my alarm clock on it. I contacted Bethany and told her to notify my travel insurance company who promptly stated my policy didn’t include theft protection (despite it being on the written policy, the fine print stated it was not inclusive). I got rapidly depressed, scared, and thought I will be spending my birthday, Halloween, the next month here I felt like I had a bag over my head. Sweaty, dehydrated, tried and scared my mind filled with thoughts of the worst things and I panicked. I went back to the cyber café and told Bethany, my girlfriend, that I wanted to come home.
I came back to the hospital and told the head doc, Helen, and David that my ipod couldn’t be found. At first, their condolences were given and I thought they were sort of BS, but then something later struck me like a sledgehammer to the face. As we were saying grace before dinner, they spent all this time praying for God to help me find my IPOD touch because they could see how distraught I was without it. Then only AFTER did they pray for the girl with the collapsed lung full of pus who would likely die in the govt hospital. I didn’t know how to feel really, but I felt something. Was I so dependant on technology that I nearly had a mental breakdown when I felt that link severed or was this a matter of personal safety? I don’t really know but it was a powerful moment.
Afterwards I took a freezing cold shower (didn’t realize the power switch to heat the water was outside the bathroom) and went right to bed. I was falling asleep in my dinner of rice and beans earlier. It was then that I realized that my bunk bed was a 1 inch thick piece of foam on wooden slats. My weight meant that I was essentially sleeping on the wooden slats but despite the soreness, I fell right asleep I was so drained. At home, I had to have the AC on and the fan on to fall asleep-obviously, none of these things are available. Heck, we have candles everywhere because electricity doesn’t work frequently.
I passed out typing this message, but couldn’t sleep well because of nightmares about family members dying and being kicked out of Best Buy, because I smarted off to an employee about an extended warranty (yes, this is what I dream about). Once awake, I couldn’t sleep again because of thought that if I get sick or injured - I could end up dying here. I know it’s morbid, but it takes almost 10 hours to get to Europe and a day to get to the states. If I needed medical care, it would have to be in Nairobi and the medical care there is questionable at best and I would have to get a flight back there. It looks like I am going to have to learn Swahili as almost no patients speak English. I’ll let you guys know how this goes.
Well, the sun is coming up and the chickens are crowing-let’s see if today is any better. I miss all of you dearly and wish I could be there to hug all of you. You never know how much you miss something until it is gone.
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