The time of my life!

We arrived at Maasai Corner and got the grand tour which was nothing short of incredible. The whole facility was constructed with mostly concrete and either steel roofs or weaved thatching. The detail was amazing in some areas while I could see some from America would turn up their nose to other details. For example, the shelves were all concrete and not level. These were purely functional and did well for what it was intended while not aesthetically pleasing. The concrete floors, however, were high quality even for standards back home. They were dusty and hidden from the construction but when wiped with a wet cloth, they revealed beautifully colored and polished concrete floors. The locals also spent three of those months hand digging a 110 foot well—looked like a good four stories down or so! I have to say I respect their hard work and am impressed with the construction skills they have. 

Church itself was good but I think I experienced quite a bit of culture shock through the service. The music was well done and I could tell everyone enjoyed the worship but everything was in Swahili. It was a blast to watch the kids dancing to the music and Courtney even got up on stage and danced along with the music pastor. The sermon was done by Chris Hopper with the local pastor translating at his side which was about the only thing I could really understand. 20-30 people were baptized after the service in the new baptism tank as well now that it was completed.

Then we moved into the newly built clinic right away where we used the facility for its intended use for the very first time. I was told the builders worked until 2am the night before just so we had running water for the day. This consisted of one sink, an American style toilet and the beginnings of a shower stall fed by the newly erected campus water tower. The first thing I noticed was that the waiting room consisted of benches around a mango tree I found it amusing to ponder how affronted patients at home would be if they had to receive care in these conditions. We opened the clinic after church service which by the end of service had approximately 100-200 people waiting to be treated! Keep in mind they had to walk for miles to get here and we only had three caregivers: Whitney, a dentist, and Lisa and I, both of us nurses. Whitney and his help are all-stars by the way; they were cruising through patients all the while fully gowned in the heat and no a/c. Even with the speed they were going they had to devise a sort of triage for their patients because the need for dental work was just too great. 

We weren’t with out our own challenges. Lisa pointed out that the local doctors in Kenya generally do not actually practice and instead “oversee” an average of 12 or so national clinics. She shared countless horror stories about the care these people received but it really hit home with a particular patient seen that day. This one poor man of about 40 years had received care at a state hospital for some blood in his urine. For some reason, the doctor chose to insert a suprapubic catheter into his bladder for this problem. This is a highly invasive surgical procedure. While I don’t know the specifics of his initial symptoms, this seems like overkill to me and wildly unnecessary specifically for a man that very likely cannot return to the hospital at his leisure. To make matters worse, the catheter site was now infected as was his urine. With further questioning we found out he has had it in since February and had no idea when he needed to follow up or even why he had it done in the first place. I wanted to take it out right away but didn’t know how to safely do this. The only thing we could do was give him the strongest antibiotics available and send him back to the very clinic it was inserted to have it removed immediately. I felt terrible and really helpless at that point having to send him back to the place that did this to him. I fear he still might not follow up for removal and medical care.

The government is very corrupt here and do not seem care about the health of their people at all. Going through the usual channels for local nursing certification is rife with crooked people expecting kickbacks. One official attempted to make Lisa pay $13,000 dollars in order to receive her local RN license. She refused of course since she could at least still work as a guest. While this was with restrictions and more limited, it is better than nothing. 

Available medicines are so scarce I don’t know how she manages to care for the people at all. There are no local FDA regulations like in the states, so the dose concentrations vary widely at the local pharmacy aka “chemist’ and not reliable. I was worried about running into a true medical emergency since we only had a half dozen vials of IM Decadron for “those that are really hurting” to quote Lisa and a couple of packages of antibiotics. Antibiotic supplies were available in very limited variety and volume, namely Cipro, Zithromax, and Flagyl. We did also have a decent supply of worm medication from America which was good because we were handing it out like it was candy to our patients. No lacerations or abscesses yet, thank God. I get nervous about the thought of having to stitch up or cut into a person in this environment.

We got to see 47 patients in about 3 hours when all was said and done. The rest had to go home which I felt terrible about. I’m certain people would riot at home if we had to do this at the ER. Over all it went well with the majority of patients just needing medication for STDs, ear infections, and general aches and pains. 

All in all, I’ve been having the time of my life.
Chris Thames.