Maua week post # 4

(Blogmaster's note: the photos enclosed are not of any patients in the clinic, but must be occasional visitors outside?)

There are several options of getting from one place to another, other than walking.  One mode of transportation is the motorcycle. We are amazed that so many persons fit on one motorcycle – often three or four, but the record we saw was five! The motorcycle is often free but the driver sometimes picks up paying passengers. Another type of transportation is the matatu – a car or van that crowds in more people than you ever thought possible and goes to a particular destination, dropping people at various spots. The matatu fee is very cheap, only KS50 (68 cents) to go up to 20 miles.  Trucks, buses, and private cars occupy the main highways, but motorcycles, matatus and foot traffic are the only ways to travel on the more remote roads.  Even paved highways are not especially fast.  If there are not many pot holes to slow you down, there are speed bumps.  Speed bumps, used instead of the speed limit signs we see on our highways and placed before city limits and school crossings, are effective.  Driving at night can be very hazardous. It’s almost impossible to see the speed bumps or the people walking along side the road.  In addition, some truckers are anxious to get to Nairobi as soon as possible and drive at suicidal speeds.

Several of you have asked what we eat.  Our diet is similar to what we eat at home, but with the addition of fresh pineapple, bananas, papaya, and other fresh foods available at the informal market.  Two small grocery stores offer a minimal selection of items but we are able to buy milk, juice, and bread there.  We’ve yet to try any of the local “butcheries” (meat markets) so our meat selection is either canned or frozen. “If you can’t cook it or peel it, don’t eat it” is our motto in order to avoid digestive problems.  We also pay special attention to the water.  We get well water from a near-by tap, but then either filter or boil that water.  It’s hard to remember to use this purified water for all drinking purposes, even to brush your teeth!  But so far, we have stayed healthy, even though our diet is simplified compared to what we eat at home.  Knowing that some of the people here in this area only have one meal a day makes us grateful for any food, even if it isn’t gourmet.

We are fortunate to have friends who welcome us to the area as well as to the hospital.  Dr. Claire  (they just use the title and first name here) is in charge of the Palliative Care Dept and of the Medical Store.  Sister Barbara (they call all senior nurses “sister”) is the acting principal for the School of Nursing.  They kindly invited us to go with them to Meru National Park last Saturday.  Meru National Park is not as famous as Maasai Mara, the destination of so many safaris, but it features many of the same animals and is only an hours drive from Maua.   Meru Park is also more unspoiled, pristine, and uncrowded.    We saw only three other parties in the park that day.  We must have visited at the ideal time; the scenery that had been brown just three weeks before was now a spring green, and the mountains were still visible in the background.  Yet the grasses were not yet so tall that they obscured the animals.  In only one day, we saw elephants, giraffes, zebras, cape buffalo, ostriches, gazelles, hippos, and many more.  We did not spot any lions or other cats, but were assured that they are there – somewhere.  I felt as if we were on a movie set and Roger, of course, took over 300 pictures.

                                               

The medical community at Maua Methodist Hospital is very hierarchical, and Roger has had to tread carefully to fit into “the system” but also to contribute his ideas and stimulate discussion among the doctors, interns, and nurses.

Roger had begun preparing for work at the hospital months before we came.  He noted that World Health Organization statistics showed that child mortality declined by 50% in the last ten years, but infant mortality had not decreased at all.  So Roger began re-training in care of the newborn while we were still in Pocatello, Thanks to Dr. Lloyd Jensen, other pediatricians, and the nurses at PMC, Roger updated his skills and did research on care of the newborn.  He also used some of the funds raised to buy special medical equipment.

It took a tragedy to illustrate the need for special newborn care.  The nurses and interns were devastated when they failed to resuscitate a critically ill baby.  That is when the Charge Nurse told Roger that the nurses and interns  needed some special training NOW.  Roger brought Resusci-Babe (a special mannikin of a new born) and a special breathing bag for newborns to the ward and began discussions and practice on newborn resuscitation.

Since then, Roger has scheduled seminars on care of the newborn with each of the departments at the hospital where small groups can have hands-on experience and all the discussion they want.  He spoke to all of the student nurses about the importance of newborn resuscitation, then saw the senior student nurses show up the next day to experience newborn resuscitation techniques for themselves.

Roger is also seeing other pediatric cases.  In only two weeks, Roger has dealt with malaria, pneumonia, asthma, kwashiorkor (severe malnutrition) and mother/child blood incompatibility.  He is excited that he is able to work with the medical staff here and to provide some crucial medical care.

I have to be more flexible in my role. A lack of medical training and inability to speak kiswahili present some barriers, but I have been able to explore the types of outreach projects done by Maua Hospital.  So far I have visited some of the families of AIDS orphans helped by Giving Hope.  I also observed HIV/AIDS classes at primary and secondary schools, supervised by the hospital’s Community Health Dept.  The department also sponsors Palliative Care for cancer and AIDS patients in their homes or communities and I plan to visit those too. When not visiting and observing outreach projects, I work in the Medical Store helping to sort out and identify medicines and also work for Community Health assembling packets of drugs for the Palliative Care patients.

Church and community fund raising efforts for medicines and supplies are much in evidence now.  In addition to Resusci-Babe and a special resuscitator, there is a special needle used to re-hydrate a patient through the bone marrow, a needle that has already saved a child’s life.  Other medicines and equipment are awaiting classification and inventory at the Medical Store.