I wouldn't necessarily classify my job as difficult, technically my job isn't even a job, more like a voluntary position. But there are moments, even days, where I wonder whether or not I will be able to continue. I wonder if God gave me enough strength to be in the position that I am.
Friday was one of those days where I questioned my endurance. Friday was a clinic day -the last day of a five day temporary clinic at Mathare North. For four days doctors, nurses, and residents had devoted their time to attending to the needs of the community. People flocked in the hundreds to the school where we had set up camp. It was a simple set up, one tent for triage, a courtyard for waiting, 3 consultation rooms, and an office that was set up for pharmacy. Each tiny consultation room was divided into two sections, each hosting either a kenyan or american doctor and a translator. The rooms were dimly lit, with the only light being the few rays that filtered through the cracks in the door. The clinic by any American standard would be scoffed at, but for these people of Mathare, it was the best care they would probably ever receive.
This particular Friday I worked triage, frantically taking blood pressures, height, weight, temp, and chief complaint -trying to smile all the while remembering the key Swahili phrases I had learned. It was a race against the clock to get as many people seen before noon that day when the clinic would close. The doors would shut shortly after noon, the doctors would eat lunch, and then be on their way to get ready for their trip back home. It wasn't until 11 o'clock that I started really getting nervous. We had been triaging patients for over three hours, and there was still a mass of people yet to be seen. We weren't going to make it. The sinking realization swept over me like a heavy shadow, and as I looked into the crowd I couldn't help but pick out the faces of desperate mothers. We would have to send them home, we were going to turn them away. Thirty minutes later the truth that I knew was coming settled on the camp. No one wanted to accept it, let alone inform all of those who were waiting. I don't know how it came to be my job, but before I knew it, I was standing in front of the crowd, "Pole sana (very sorry). Mganga anakwende nyumba (the doctors are going home). The clinic is closing. Tefadali Mkwende (please go)."
There wasn't the uproar that you would expect in the US. No one stood up and shouted at me.... it was worse. There started a low murmur, then when the murmur progressed to the point where more and more people understood what was happening, there were groans, sobs, and women pleading. It wasn't loud, it wasn't rude, it was desperate. I wanted to tell them I would visit them all, I would stay until sundown if it would help, but I could do nothing. Ashamed, and afraid I would bust into tears if I remained any longer, I retreated behind the comfort of the school walls. It was here that no one could see me, no one would notice my frustration, fear or anger.
But, my job was not done, I had to clean up the triage area. Bracing myself, I stepped outside and returned to my position, only to rip the measuring tape off the wall, collect the thermometers, and scoop up the blood pressure cuffs. Somewhere between tracking down all of the alcohol swabs and retrieving the charts, she found me. She was no more than 25 years old, and with her was this precious little girl. "Please, " she begged me. "Just look at her head; just for a second."
I looked. After seeing hundreds of small children with white round patches on their head, I knew exactly what this little girl had -tinea capitis, otherwise known as ring worm. Once someone in the family gets it, usually all the kids get it because the sleep practically on top of each other in their one room shantis. But hers was different. Her head was infected. Sometimes this happens which a child scratches the fungal infection, then a secondary infection sets in, and due to constant scratching and unsanitary conditions, the infection spreads. Well, it had spread alright -all over her head. Yellow puss was weeping from her wounds which covered about a third of her scalp. "Please, will you help her?"
What could I do? I tried to tell her I wasn't a doctor. I tried to tell her that there must be other clinics in the area that she could visit. I was lost for words, and desperate to leave the situation. How could I possibly explain? How could I convey my great saddness that I could not fix her child, how could I tell her I did not wish to be so cold hearted, but one exception would lead to dozens of exceptions which could not happen because the doctors were litterally packing up their bags and leaving.
Once again I returned to my refuge, but this time all the more shaken up. I didn't go unnoticed. Amos, one of the Kenyan nurses approached me and asked if I was having a rough day. Not necessarily prepared to go into detail about how things were going, but not so confident to completely bluff, I summarized with, "yes, it's been a rough day, and turning away people is wearisome." Then, I simply asked what could be done for a small girl who had an infection -should she be turned away. His response was surprising -he told me to get her a card, write down these meds, and stick her in the line at the pharmacy. She wouldn't have time to get in for a consultation, but he knew what she had, I knew what she had, and the solution was simple, and her condition should not have gone without treatment. In a flash I dashed out of the room, grabbed a chart, filled out the meds, signed my name like Amos told me to, then found the woman. I jotted down her daughter's name, pulled them aside, and told them to stand in line. When they got to the lady at the window, she was to hand her this card, and then follow her instructions on how to take the meds. She thanked me, and then pulled out another little girl -with the same problem. "And this one," she asked.
Before I knew it mothers were bringing over their children, even fathers were approaching me. They all needed treatment. My efforts to be discrete were in vain, I was soon being swarmed by desperate people. Why had I made the one exception, was I wrong in my efforts to help?
The doctors were done seeing patients, the only people left at the clinic where those in charge of pharmacy and those who were directing people. There was no hope to give these people, and in the pit of my stomach I shared in their desperation. For the last time I retreated, I knew it was over, and this time I did not wish to suppress the tears. I sat in the corner, weeping for these people, weeping that they would not get care today, weeping because there was nothing else for me to do. My nerves were raw, all emotions were exposed.
It wasn't until later that day that I could start to feel again. I had been given some words of encouragement from a very wise friend who has been here longer than me. She told me that God uses our weaknesses to show us something about Himself. God is stronger than any medicine we can give. Medicine can treat, but Christ is the only one who can truly heal us. There is something beautiful about fully trusting in Him to be our savior -our saviour in times of injury, sickness, and desperation. God is provider, healer, comforter, and refuge. All too often I think we rely on ourselves to carry us through, but so much more- no, all of our reliance should be on Christ. Even my own frustration and sadness today came from feelings of inadequacy. I know I cannot heal these people, I cannot even get them to see a doctor, but there is someone I know who can. My hope is in Christ, and my refuge should be in Christ. Strength comes from the Lord, and his power is far beyond my understanding. These are his children, and he cares for each one. It is a difficult concept to consider, and even more difficult to accept, but I must take comfort in the knowledge that He is a just and compassionate God.
As I shuffled through all the charts of the patients that had been seen that day, I noticed one that stuck out. There, scribbled across the yellow slip of paper, was very familiar handwriting ordering Griso 250 and some Clotrine-B. Christina -that was her name. She was one of the 150 who received treatment, and as I added her card to the pile I couldn't help but smile. She is a child of God, a beautiful sweet child.
Monday, October 25, 2010
Wednesday, October 20, 2010
Medical Clinic
Thus far on this adventure in Africa, my favorite days are clinic days. More precisely, I enjoy the short term teams that operate in different communities within the Mathare Valley. Each week, short term missions teams bring medically trained professionals willing to devote their time and talent to the people of this region. Schools, churches, and even meeting rooms are transformed into temporary clinics and the US staff joins arms with Kenyan professionals in a cohesive effort to meet the medical demands of the community.
Within a matter of a few minutes, a classroom becomes a consultation room, an office a pharmacy, and the small "courtyard" outside hosts triage. Members of the community flock to the center. Some are sick, others wish simply to take advantage of medical attention while it is available. Mothers come with their children -often a half dozen of them, all with the same ailment -tinea capitis (ringworm on the head).
I usually hang out in triage. Generally I aid in collecting hight, weight, temp, BP, and then with the aid of a translator, I dictate chief complaint. After the patient has been through triage, they are off to consultation with either a nurse practitioner or a doctor. While they wait for the pharmacy to fill some scripts, generally there is someone going over some health education. This is the area of medical clinics I wish to see grow. While distributing medication may relieve some of the symptoms and perhaps treat disease, it can do nothing to change the perspective of the people. If the same habits and attitudes about health are maintained, then the reoccurrence of whatever brought them to the clinic in the first place is highly likely. Prevention is key, and education is power.
I fear that because health education does not have immediate results like a bottle of antibiotics, it is considered less effective and less pertinent to the rotation of these clinics. Specific focus needs to be aimed at education if we hope to make a change in Mathare. Bandaids only soak up the blood after the wound, but would it not be much more effective to avoid injury? Can not the education of one individual spread exponentially? But what good is knowledge if it is not shared? What power do idle lips carry?
What I have come to learn is that I do not need my doctorate to open my mouth and share medical knowledge. While my knowledge may be minimal compared to a professional medical worker, the truth is that I have something to offer. In-fact, anyone who grew up in the US had medical knowledge that should not be taken for granted. How many people know how to wash their hands? How many people know how to clean a cut? How many people know to cover their mouth when the cough? How many people know to drink water when you have diarrhea?
Education -it really is the key to change.
Within a matter of a few minutes, a classroom becomes a consultation room, an office a pharmacy, and the small "courtyard" outside hosts triage. Members of the community flock to the center. Some are sick, others wish simply to take advantage of medical attention while it is available. Mothers come with their children -often a half dozen of them, all with the same ailment -tinea capitis (ringworm on the head).
I usually hang out in triage. Generally I aid in collecting hight, weight, temp, BP, and then with the aid of a translator, I dictate chief complaint. After the patient has been through triage, they are off to consultation with either a nurse practitioner or a doctor. While they wait for the pharmacy to fill some scripts, generally there is someone going over some health education. This is the area of medical clinics I wish to see grow. While distributing medication may relieve some of the symptoms and perhaps treat disease, it can do nothing to change the perspective of the people. If the same habits and attitudes about health are maintained, then the reoccurrence of whatever brought them to the clinic in the first place is highly likely. Prevention is key, and education is power.
I fear that because health education does not have immediate results like a bottle of antibiotics, it is considered less effective and less pertinent to the rotation of these clinics. Specific focus needs to be aimed at education if we hope to make a change in Mathare. Bandaids only soak up the blood after the wound, but would it not be much more effective to avoid injury? Can not the education of one individual spread exponentially? But what good is knowledge if it is not shared? What power do idle lips carry?
What I have come to learn is that I do not need my doctorate to open my mouth and share medical knowledge. While my knowledge may be minimal compared to a professional medical worker, the truth is that I have something to offer. In-fact, anyone who grew up in the US had medical knowledge that should not be taken for granted. How many people know how to wash their hands? How many people know how to clean a cut? How many people know to cover their mouth when the cough? How many people know to drink water when you have diarrhea?
How did the chicken cross the road?
In case my last blog did not keep you thoroughly entertained, I thought I would supplement with some classic Kenyan humor.
Things that Kenyans find everyday/mundane, the average American would find, well, simply odd.
So my question is, "how did the chickens cross the road?"
-"by mutatu of-course!"
(Mutatu is the public form of transportation. Generally dangerous, smelly, and crowded, and always loud. But also inexpensive. Also noteworthy, is the fact that I have yet to ride a mutatu without a memorable experience.)
Things that Kenyans find everyday/mundane, the average American would find, well, simply odd.
So my question is, "how did the chickens cross the road?"
-"by mutatu of-course!"
 |
| Chickens ride free on mutatus |
Driving 101
 |
| Driving to work |
Because the British have such an influence in Kenyan culture, Kenyans drive on the wrong side of the road -that is to say, the left side. Convinced that I needed to feel independent, the Kamaus (my Kenyan host family) so graciously offered the car keys to me. On my fourth day in Kenya I was given all the privileges of of a 16 year old, along with additional fears and anxieties. I was told not to worry, I could drive in the US, so driving in Nairobi should be natural.
Natural! ha! Everything that I learned in the US should be thrown out the window. Other than turning the key and adjusting the seat, nothing is the same. I had observed Wallace Kamau driving through the city, and often times I closed my eyes and prayed for fear that if I continued to watch I would not be able to suppress the screams of fright as we narrowly missed head-on collisions with mutatus and motor bikes. The rule in Kenya is that there are no rules. Terrifying. People will cut across four lanes of traffic to make a right-hand turn (remember this is opposite US driving). Where there should be two lanes, four will suddenly emerge as mutatus can pass on either side. If there is not room to pass, they will make room -this leaves pedestrians to fend for themselves. That in itself is a whole other situation. I have never seen so many pedestrians in my life. In America, whether out of the kindness of our hearts or fear of a lawsuit, we make sure to give the pedestrian plenty of space. In Kenya, so long as someone doesn't die, everything is ok... and even then, I am not sure what would happen. People run across roads with reckless abandon, sometimes dragging children, other times carrying crates, juggling chickens, or pushing wheel barrows. In kenya you must be ready to stop. You must watch people from every angle, and you must be ready for anything -like the truck that drops sticks, the mutatu that jumps the curb to pass, the lady with chickens who just stands in the middle of the street, and especially the motor bike that fancies driving in the your lane because his lane is too congested.
Ah yes, Kenyan driving. There are speed limits, but they are never followed. Instead, to assure a safe speed, there are speed bumps avery 400yds -0%exaggeration. There aren't always road signs, and round-abouts are a bona-fide mess -may the bravest car win. Needless to say, driving is different.
Back to my story: First day of driving lessons, actually first five minutes of driving lessons, I am rounding a corner coming out of the neighborhood, and here comes this enormous truck. Anyone who works with HUGE trucks would appreciate the size of this thing. There was nowhere to go, so I do what instinct would tell me to, I start to pull over to the side of the road, hoping that a few extra inches will save our lives. Instead what I found, or what the tire found, was a huge piece of concrete conveniently placed where I could not see it. MPUUUUSHH -there goes the old tire. Talk about embarrassing -not only am I driving the other interns to work, but Mary, Wallace, and their two children are in the car. Then, on top of that, I think every pedestrian, motorbike, and car stopped to see what was going on and how they could help. Luckily, out of the some 30 people who stopped, someone knew how to change a tire. So, with the new donut in place, we were off again -with me in the driver's seat.
Oh yes, there is no better time to get back on the horse than right after you fall. So, I drove us all the way to Mathare that day, and everyother day since that incident.
So, what is the lesson? Don't drive into concrete blocks :)
Tuesday, October 5, 2010
Sometimes its hard
Sometimes it is hard to put into words exactly how you are feeling. I have attempted to write a new post for a while now, but every time I start, I re-read what I have written and feel discontent. To be quite honest with everyone, I am not sure of how I feel right now.
There are so many emotions that are experienced throughout a day here in Kenya, that I am generally exhausted by dinner time (my tired state could also be due to the rooster that crows periodically all day, and all night long, but that can be another entry).
My time here in Kenya has been such a blessing. Each day is a reminder of God's excellence, His power, and His grace. It is such an encouragement to be working with people who are so passionate about loving God and loving others. Passionate people are so necessary in this field. Day-to-day experiences are so difficult, that anyone who is anything less than passionate, committed, and empowered by the love of Christ, is not going to last more than one week. I thank God for the people at MOHI, because they fill me up -I fuel up on the excess love that pours out from them. There are days when I do not feel like the up-beat, go-get-em Christian that I want to be. I get out of bed and I do not feel overwhelmed by the love of Christ. And yet, I get to the center, I see my teammates' (fellow CHE members) faces, and I feel it. It is an exhilarating attitude that captivates my being and anyone else who happens to be in the room with them. They are such a great reminder of what is happening here in Mathare. When Christ comes into your life, he fills you up so full that you alone cannot contain the love, and it just pours out from you and fills up those around you.
Mathare is huge, and right now there is a lot of people who have never heard of the love of Christ. But when we move out into the slums, when we bring the light of Christ, I see that same love pouring out. I see people being filled with hope. Walking down the streets of Mathare I see love radiating from this team. They walk with purpose, with passion, and with a desire to see that all of God's children feel the love.
When I am in a slump; in those moments when I doubt I can make a difference, my prayer is this, that God would fill me up. He promises to fill us up until the point where his love flows out of us, and I believe his promises. Mathare valley needs people to walk the streets and to pour out Christ's love. Illinois needs people to walk the streets and pour out Christ's love. Michigan needs people to walk the streets and pour out Christ's love. ____(fill in the blank) needs people to walk the streets and pour out Christ's love. I know that whatever I face, I know God is faithful to fulfill his promises. When I come to him asking to be filled, my cup will overflow. So now all I have to do is take that cup to the streets, so that where I walk, the love of Jesus would just flow out.
I guess it's time to take a walk.
There are so many emotions that are experienced throughout a day here in Kenya, that I am generally exhausted by dinner time (my tired state could also be due to the rooster that crows periodically all day, and all night long, but that can be another entry).
My time here in Kenya has been such a blessing. Each day is a reminder of God's excellence, His power, and His grace. It is such an encouragement to be working with people who are so passionate about loving God and loving others. Passionate people are so necessary in this field. Day-to-day experiences are so difficult, that anyone who is anything less than passionate, committed, and empowered by the love of Christ, is not going to last more than one week. I thank God for the people at MOHI, because they fill me up -I fuel up on the excess love that pours out from them. There are days when I do not feel like the up-beat, go-get-em Christian that I want to be. I get out of bed and I do not feel overwhelmed by the love of Christ. And yet, I get to the center, I see my teammates' (fellow CHE members) faces, and I feel it. It is an exhilarating attitude that captivates my being and anyone else who happens to be in the room with them. They are such a great reminder of what is happening here in Mathare. When Christ comes into your life, he fills you up so full that you alone cannot contain the love, and it just pours out from you and fills up those around you.
Mathare is huge, and right now there is a lot of people who have never heard of the love of Christ. But when we move out into the slums, when we bring the light of Christ, I see that same love pouring out. I see people being filled with hope. Walking down the streets of Mathare I see love radiating from this team. They walk with purpose, with passion, and with a desire to see that all of God's children feel the love.
When I am in a slump; in those moments when I doubt I can make a difference, my prayer is this, that God would fill me up. He promises to fill us up until the point where his love flows out of us, and I believe his promises. Mathare valley needs people to walk the streets and to pour out Christ's love. Illinois needs people to walk the streets and pour out Christ's love. Michigan needs people to walk the streets and pour out Christ's love. ____(fill in the blank) needs people to walk the streets and pour out Christ's love. I know that whatever I face, I know God is faithful to fulfill his promises. When I come to him asking to be filled, my cup will overflow. So now all I have to do is take that cup to the streets, so that where I walk, the love of Jesus would just flow out.
I guess it's time to take a walk.
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