A Doctor's Kenyan Adventure 2005

26/12/05-31/12/05

2005-12-31T14:39:00.000+03:00

Well, after Christmas we started back at work on boxing day at Dophil clinic with Dr. Philip. Phil did a couple of circumcisions - I'd had enough of those after my first week. He showed the doctors how to do a nerve block instead of having to inject local all around the base and tip of the penis causing alot of unnecessary pain, screaming and writhing in little boys! I guess it beats the traditional African way of no anaesthetic and the same rusty tool being used on several boys one after the other! We were both slightly worried about the fact that they used lignocaine with adrenaline in the penis as it could cause damage to the blood supplyand thus necrosis.

The rest of this last week I've seen many of the usual cases of malaria, pneumonia, gastroenteritis and complications of HIV/AIDS. I've had to do alot of counselling of patients who are obviously severely immunocompromised but are too scared to get tested or who are in denial. One case that affected me alot this week was of a 10 year old girl who lives just close to us in Wagai. She came in with a temperature of 41 and stomach pains - this was one of many admissions in the last 6 months. We immediately got her temperature down and started treating her other symptoms. Dr. Philip had been treating this family for many years and he strongly suspected HIV as a cause for this little girl's complaints. He asked me to have quiet talk with her mother - a well-known, well-educated, up-standing member of the local community - someone I see often around the village. It was quite difficult broaching the subject with her but in the end she told me that she had finally plucked up the courage to get her daughter and herself tested a few months ago and the result was positive. I asked whether or not the daughter had been commenced on anti-retrovirals but apparently her CD4 and other baseline tests had not yet been done so I organised for this to be done. Luckily the governement now covers these costs otherwise very few would be able to be afford to get tested and commence treatment if needed. The mother was quite emotional when she spoke to me of her fear and guilt over her daughter's status - I had to fight back tears as I listened...

This weekend we have returned to Kisumu for modern day conveniences such as internet, flush toilets, hot running water and electricity! We are staying at reasonably priced hotel called the Sunset which is extremely beautiful asit is located just on the shores of Lake Victoria. There is a fabulous view of the lake from the room - I witnessed the most spectacular sunset yesterday - the burning red sun slowly decended into the depths of the lake on the horizon. Eagles circle above the trees by the lake just outside the room. Very relaxing!

Christmas Day 2005

2005-12-31T12:50:00.000+03:00

On christmas day, we awoke at 10 and waited for Alfred to pick us up from the hotel in Kisumu to take us to the orphanage to deliver gifts and sodas and sit down for lunch. Fletch had told us to be there by 12 as we wanted to have time to take the kids down to Wagai sports ground for all the games and festivities after lunch. Alfred's church service overran so he was an hour and half late! After a somewhat annoying morning we finally arrived with the gifts and sodas at the Ulamba orphanage (built by Moving Mountains and AA volunteers last summer). As we walked in we were greeted by the district Chief, the Mama and the watchman. My eyes were immediately drawn to side of the room where the kids were neatly and quietly sitting waiting for their christmas lunch. As soon as they caught sight of Phil and I (new mzungu and chinese mzungu faces) they were immediately excited and eager to greet us. They were absolutely adorable and so well behaved! I met Ruth, Sharon, Colinz, Mike, Kevin and Victor - all with big, enquiring eyes and happy faces! The lunch spread was great - kenyan chapatis, rice, irish potatos, ugali, chicken stew, green dal and fried cabbage.

After lunch, Fletch gathered the kids outside to open their presents on the grass. They were so happy and enthused - it was really heartwarming to see! Phil, the chief and some of the kids played football for a while. As the kids were playing, I started taking video footage of them - they were fascinated by the technology and started dancing and singing for me - quite literally going crazy with elated excitement - I couldn't stop laughing and neither could they - what a fantastic christmas afternoon!!

We gathered the brood up and got them ready to go for the sports and fun in Wagai. After waiting a good half hour for a matatu we finally got to Wagai. Fletch was pushing Sharon in her wheelchair while Phil and I held the kids hands as we waded through the crowds on the sports field. As soon as we got there we were mobbed by hundreds of curious onlookers wanting a glimpse at mzungus and paying particular attention to Sharon and her wheelchair. We tried to move away but they just followed us everywhere - it was quite scary and the kids were a bit nervous about it too. In the end we had to make the decision to leave and go back to our house in Wagai as it was impossible to stay down there which was a great shame for the kids. More football by the house and a few sodas later it was time to take them back to the orphanage - exhausted but satisfied!

That evening Fletch, Phil and i drank 3 bottles of red wine and got fairly merry. Steven and Meschak took me to the disco under a marquee in the field near our house. we danced the night away to reggae, ohangla and other african beats - everyone was very friendly and it was great fun! I was complimeted many times on my strange ability to dance - something whihc Kenyans think mzungus can't do so well - I guess that's on account of me being only half mzungu and half Indian (pretty renowned for dancing!).

I returned home tired at about midnight and Phil snapped this candid shot of me brushing my teeth outside our kitchen - you can see our outhouse and the tops of some maize from the field in the shot too- it's actually quite nice getting ready for bed underneath the african stars! The dance beats went on and on and on and on and on until about 7 in the morning which made for a rather interrupted night's sleep!

7/12/5 - 24/12/5

2005-12-24T13:47:00.000+03:00

I was both excited and apprehensive as I sat in the departure lounge at Heathrow Airport waiting for my flight to Nairobi, Kenya. I had just passed my medical school final exams, was officially a doctor and had 8 weeks of free time ahead of me before beginnning my job as a Pre-Registration House Officer in February 2006. As such, I decided to use this time to gain valuable experience practising medicine in setting with extremely limited resources, in a country battling poverty, famine and the scourge of HIV/AIDS. As I have a special interest in immunology and HIV, travelling to Western Kenya, Nyanaza Province offered the perfect opportunity to widen my experience in this arena: Siaya District is particularly badly affected by HIV/AIDs with an estimated 50% of young people infected with the virus. Fifty percent of the population is under 9 years old and there are many orphans. I sorted out the trip last minute through a charity Moving Mountains and their sister company Adventure Alternative (AA).

I really had no idea what to expect when I got there but I was pleasantly surprised when I landed at Jomo Kenyatta Airport, Nairobi and was greeted by a bubbly and welcoming member of AA staff called Rosie. She immediately made me feel at home. I was very tired as I had hardly slept during the 8 hour journey as a result of all the nervous energy effervescing inside me as I anticipated the next 6 weeks in Kenya. Wide-eyed and exhausted, I was taken by Rosie and Gerard (the friendly taxi man) to the Kibera slums - the epicentre of Moving Mountains' work in Kenya. It was a shocking and humbling experience as I met and talked with the former street kids about their lives and their work trying to get other children off the streets, building health clinics and orphanages throughout Kenya. The reason I had given up journalism and entered medicine was to try and make a real difference in people's lives, to help in any small way I could. I found that this desire was slowly beaten out of me during medical school and a hard cynicism and selfish pragmatism had eaten into my very soul. Even on my first day in kenya, my soul was slowly being revived. The attitude and atmosphere in Kibera was infectiuosly positive - I was very happy!

I was then taken to the Giraffe Sanctuary where I met a very friendly and hungry giraffe - the giraffe hoovered food pellets from my hand with a Homer Simpson-like enthusiasm! We were supposed to take the overnight bus to Siaya but as the day wore on I realised I was becoming sick. In the end I decided it best to stay the night in a hotel in Nairobi and take the plane to Kisumu the next day after visiting Nairobi Hospital for some antibiotics. Kisumu is the 3rd largest city in Kenya, situated on the shores of Lake Victoria and 1 hour's drive from the village of Wagai where the AA house is - my home for the next few weeks!

When I alighted the plane in Kisumu, the sun was setting over the beautiful green hills, the air was fresh and sweet compared to the stuffy polluted metropolis of Nairobi. Rosie and I took a matatu (crammed public transport vans) to Wagai. When we arrived in Wagai it was dark - v dark as there is only a couple of houses in Wagai with electricity! I met Helena and Fletch who were to be my fellow mzungu (white person) housemates for next few days. they were very welcoming giving us dinner and explaining how things work in the house and the village of Wagai. The house was very basic - no electricity and no running water! The toilet (a long drop) and shower (from a tank filled with river water) were in an outhouse! This was going to be an intersting experience! I went to bed with the sound of cockroaches scuttling about the place!

I awoke very early to the sound of roosters crowing and african music in the distance. I could tell most of the village was already up as i could hear chatter about the place. I decided to look around properly - our house backs onto a large maize field and we have two families as neighbours. As soon as I stepped out the door I was greeted by Maurice, Alice and the children that live around the place. Everywhere you walk around here you are greeted by "Mzungu , amosi (luo for how are you) or habari (swahili for how are you)". The kids are particularly fascinated by mzungus - some even cry with fear as they have never seen a white skinned person before!

So much has happened since then but I don't have time to fill in the rest of this blog until next week so you'll have to make do with some pictures for now. I will tell all later! This is me closing a c-section at Siaya District Hospital and below is me with Phil (the aussie med student doing an elective at the same time as me - we are sharing the AA house now that Helena and Fletch have left - he is crazy - I will tell you more later!) with Dr. Ochieng and Dr. Phillip (our mentors). Below is also a picture of Rosie, Osman and I under the welcome to kisumu sign at the airport!

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The other pictures are of us and our faithful driver Aflred during our trip to Kakamega Forest last weekend - we stayed in nice hotel and played golf - a far cry from Wagai! We saw many different types of monkeys and birds and had a good hike around the beautiful forest.

Finally - to my family and friends - sorry I can't be with you to celebrate Xmas - have a great time - I miss you all!! ....Especially you (you know who you are!).