Packing for Kenya
I’m twitchy and anxious. Headed for Kenya with a medical/education team organized by Spokane-based Partnering for Progress, my job will be to interview, photograph and document P4P’s work at a rural health clinic.
It’s not like overseas travel is new to me. Since I was 21, I’ve flown first and last class, slept on floors and in a high thread-count beds, eaten street food and artful gourmet meals, gotten sick and stayed well, been bitten by a scorpion and kissed by my husband.
But over the years, I guess I’ve morphed from blissfully naïve and adventurous to worldly and somewhat cautious. I know I can do my job, but I’d like to do more — to connect, to learn, to contribute. Without a stethoscope, what can I possibly add?
Across the Great Rift Valley
After an overnight in Nairobi, our team of dentists, health educators and a nutritionist, boards a van for a 225-mile drive across the Great Rift Valley to our base camp in Migori, a town of 30,000 in the southwest corner of Kenya. From there we’ll travel back and forth each day along a dusty, pock-marked road to a rural health clinic in Kopanga village.
Small huts, farm plots and fields are scattered across the wide valley with its dramatic escarpments, numerous volcanoes and the vast Masai Mara National Reserve. Flat-topped acacia trees dot the dusty green plain where men herd donkeys carrying 10 gallon water jugs and Masai tribesmen wrapped in traditional red blankets tend goats and cows. Motorbikes loaded with mattresses, crates of eggs and way too many people zoom straight at us then veer into the narrow opposite lane.
Leaving the valley, we pass kiwi-colored tea fields, shabby towns of tin and wood and trash littering every ditch. The cool morning air has given way to dry heat, a fine layer of red dust covers everything.
After six long hours, we reach Migori, walking distance, by African standards, from Tanzania. The next morning we head for the clinic in Kopanga. The village, and by extension, the clinic, has no running water, limited electricity and very few latrines. Poverty is widespread and educational opportunities are minimal. This lethal cocktail contributes to water borne diseases, malnutrition, malaria, HIV/AIDs and a mortality rate of 48 and 52 years for men and women respectively.
The Circle of Life
Alice, Alice, Alice. I heard her name over and over in every P4P conversation before I left. Six years ago, she captured the hearts and minds of P4P founders as the intelligent, compassionate clinic nurse and founder. With some funding from the United Methodist but minimal supplies or financial assistance from the Kenyan government, Alice and her staff see between 900-1,000 people a month suffering from HIV/AIDs, malaria, malnutrition, water-borne illnesses and more.
I expected an African Nurse Ratchet hell-bent on repairing the afflicted. Instead, we meet a petite, soft-spoken woman heaven-bent on healing and educating as many men, women and children as possible. The need is staggering. One-quarter of all maternal deaths in Kenya occur in this province, one of the highest rates in the nation. Infant mortality is an overwhelming 95 deaths per 1,000 births, and HIV/AIDs infects 14.6% of the population compared to a nationwide statistic of 6.7%.
Alice walks us through the clinic’s exam room and recovery rooms, pharmacy and lab. In the maternity ward, where the dentists have been extracting and filling teeth in the 90-degree heat, three exam tables double as labor and delivery beds.
“We use this one for deliveries,” Alice says pointing to a low table beside the window, because I can tell the mother to put her feet on the wall and push. No, we don’t have stirrups.”
“If we have a complicated delivery or a C-section,” she continues, “we find someone with a motorcycle and hire him to take her to the hospital in Migori. We have to tie her to the back of the bike so she won’t fall off.”
Fee-for-Service
Two men have driven up on a motorcycle. The passenger’s leg is extended and his foot is tied with rags to the bike strut. Once they are admitted, Alice calls me into her office.
“He was here in October with this,” she says, clearly aggravated. An open wound the size of a baseball on the back of his calf oozes and festers. I take a photo and quickly put some distance between me and the gore.
“I think he has osteomalitis, an infection of the bone. I told him to go to the hospital in Migori for an x-ray, but he didn’t have any money.”
Medical care in Kenya is fee-for-service. No money, no health care. When I ask Alice what will happen, she sighs, shrugs and says, “He will probably lose his leg.”
The Sweetest Thing
Tiny Baby Michael looks like a doll on his father’s lap. Fifteen months old and weighing only 12 pounds, he is malnourished and dehydrated. An American baby at that age would weigh at least 30 pounds. Twenty-one percent of children under five die in this region and 14 percent never make it past infancy.
We’ve brought 10 packages of Plumpy Nut, a 500-calorie, nutrition dense supplement for the severely malnourished babies. Tasting like peanut butter cookie dough, it comes in a ready-to-dispense squeeze packet. Two a day will stabilize a malnourished baby, three a day will take them out of the danger zone. After we leave, there won’t be any more till P4P’s next group arrives in eight months.
Our nutritionist opens a packet and tells the father to put some on Michael’s finger. Michael stares at the glop. Dad puts some on his own finger and Michael goes at it like a popsicle. Soon we’re all smiling and clapping like we just watched our kid take his first steps. And in some ways, we have.
Without a Stethoscope
I haven’t bandaged a wound, nourished an infant or admonished a single person to use condoms.
But I have taught little kids how to blow bubbles, been beaten royally at jacks by teenagers, and typed heart breaking and heart lifting stories told to me by clinic staff.
My camera, laptop, curiosity and a cautious smile opened doors, giving me an uncommon glimpse into the lives and dreams of these courageous, warm and generous people. And now I’m doing the only thing I know how to do. Write about it.
Post Script. Since Linda returned from Kopanga, Partnering for Progress shipped an obstetrics table to the clinic, instituted an infant nutrition monitoring and health program, received funding to install a water system for the clinic and the village, and secured the services of a University of Washington Global Health Student to collect data and work with clinic staff. The next P4P group will go to Kopanga in October. To learn more or to volunteer, go to www.partneringforprogress.org.
