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| Angela in her shamba. |
The Kenyans are very excited
about the rain. Many people here plant
their own shambas at
home (literally, shamba means field or farm, but for most here it's a garden). For some it’s a hobby, but for
others it offsets the cost of paying for food.
With the rains beginning, the people of Mutomo are looking forward to a
better harvest. Angela, one of the
nurses on medical ward (who I really enjoy working with) has a large shamba on
the hospital grounds. She recently gave
me a tour, showing me all the tomato, papaya, sukuma wiki, and mango plants she
has. I can tell she’s very proud of her
crop. She can be found every week on
market day selling her produce in town.
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| Angela's greenhouse, growing tomatoes. |
I’ve gotten used to the routine
at the hospital now. Some days are very
good and I actually look forward to going to work. Other days I can’t wait to get home. A lot of it has to do with which nurses are
working that day. I’ve been struggling
with a few nurses who simply seem indifferent to the wellbeing of their
patients, and for me that is infuriating.
But other nurses I love working with.
For the past couple weeks we’ve had a nurse from the nursery named
Beatrice working on the medical ward.
She’s fantastic. You can tell she
really cares for her patients. She works
quick, responds immediately to the patients’ needs, and is very helpful to me
when I have a question. And she’s always
willing to translate into Kikamba or Kiswahili when I want to ask a patient a
question. She’s been a wonderful mentor
to me the last couple weeks. Today we
have a new nurse starting on the ward. I
spent a couple hours training her, showing her the regular routine of the
ward. Hopefully I can help instill some
good practices in her while she’s still fresh out of school.
We’ve had quite a few deaths on
the ward recently. Yesterday a woman
suddenly stopped breathing. One of the
Swedish doctors was on the ward at the time, and I told her to come see the
patient. She began doing chest
compressions, but after a minute we decided it was pointless since there is no
way to defibrillate the heart, and there really aren’t any cardioactive meds we
can give to restart the heart. They have
epinephrine available, but it isn’t normally used for resuscitation, and I
don’t think most people here would know what to do with it anyway. I spoke with Dr. Amolo, the veteran doctor at
the hospital, and asked if patients are ever resuscitated. He explained that they sometimes do it with
children, but it’s rare with adults; they are usually so sick that even if they
could resuscitate them they would probably only live for a few minutes before
going into arrest again. I think I’d
still like to have a defibrillator anyhow.
I’ve enjoyed working with Dr. Amolo
so far. We had a talk the other night
about the government hospitals in Kenya.
Corruption in these facilities runs rampant, and patients are often
treated only if they pay a bribe to the doctors and nurses. I can tell he’s very frustrated with his
experiences in the health system in Kenya.
He works hard to care for his patients, often working long hours. I’m grateful that such corruption isn’t a
problem at Mutomo Hospital.
Another patient was recently
admitted with a diagnosis of congestive heart failure. For almost a week he lied in bed being
treated for all sorts of conditions, some of which he didn’t have. I took a look at his lab results and could
see that his problems were clearly a result of renal failure. For you readers with a medical background,
you’ll appreciate the severity of his lab values: creatinine=12.7,
potassium=7.5, and sodium=113. We
weren’t doing anything to treat this (the hospital doesn’t have dialysis
capability). In fact, some of his
medications were actually toxic to the kidney, making the situation even
worse. I was able to have a talk with
the doctor, and we eventually arranged to have him transferred to another
hospital for further treatment. The
treatment he really needs is available in Nairobi, but the cost of both
treatment and transport there pretty much make it an impossibility. At the very least, we’ve saved him the
unnecessary expense of remaining hospitalized in Mutomo. Still, it’s sad to know that we can’t do
anything for him, and he probably won’t be treated simply because of money.
Not all of our cases are so
dismal. I’ve been working with an
elderly patient who recently had a laparotomy.
For days she was sitting in bed because nobody took the time to exercise
her. I finally managed to find a walker
buried in a pile of old equipment, and have been walking with her
regularly. The first day we just took a
few steps around the room and built up her confidence. I tried my hand at Kiswahili, using the words
for “to walk” and “help” to convey that I would help her walk. The relative understood my poor Kiswahili and
translated into Kikamba for the patient.
Each day we went a little farther, and now I see her walking around
outside without even using the walker.
Nice to see at least one patient making progress. I can’t speak with her, but her face lights
up with a big smile when I come walk her, and I’ve enjoyed working with her. She’ll be discharged home tomorrow.
A couple days ago, I was shocked
to discover that all the bottles which the patients use for drinking water were
filled with mold on the inside, green as grass!
I asked the ward assistant who was supposed to clean them, and they said
they are cleaned by the kitchen staff daily.
Turns out they were only cleaning the outsides! I spoke with another nurse about it, who took
it the administrator’s assistant and arranged with the kitchen to clean all the
bottles daily… on the outside and the
inside. I’ve been checking the bottles
every day since, and so far so good.
Thanksgiving is here! Last night I celebrated an early Thanksgiving
dinner with my neighbors. Anita, who was
kind enough to pick up a turkey and a pumpkin in Nairobi, is leaving town this
week, so I wanted to have the meal before she left.
I poured a lot of sweat into
making that meal… literally. With the
oppressive heat, cooking is no easy task, and I was dripping sweat for two
intense hours while I cooked. The menu:
turkey seasoned with rosemary, mashed potatoes (I bought my from Angela in the
market), stuffing made with sukuma wiki (a Mutomo staple), cranberries, and a
pumpkin pie made from scratch. Some
items were very cheap. Others were
surprisingly expensive.
2 turkey breasts and a drumstick:
3113 kshs ($36)
1 pumpkin: 129 kshs ($1.50)
1 can cranberries imported from
America: 3800 kshs ($44!)
2 kilograms potatoes: 80 kshs
($0.94)
1 tub of “fat spread”
(margarine): 280 kshs ($3.30)
Keeping an American tradition
alive in Africa: priceless
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| This huge mess... |
I’ve never made a pumpkin pie
before, and certainly not one from scratch.
Canned pumpkin wasn’t to be found in Nairobi, so I spent several hours
the night before the meal washing, cutting, scraping, steaming, and pureeing a
whole pumpkin! The very next day a care
package arrived from my parents at home which contained, among other things, a
large can of pureed pumpkin! So now I
can say I’ve had the experience of making a pie from an actual pumpkin, but
I’ll probably never try it again. I’ll
stick with the canned stuff.
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| ...just to make this. |
I had a lot of help from my
neighbors.
Anita made the pie crust.
Dr. Layla was busy with me in my kitchen,
peeling potatoes, making gravy, etc.
The
Swedish doctors were kind to host the event at their house, since they have a
large patio with a full dining set.
I
was surprised how well the meal turned out.
The turkey was moist, the stuffing flavorful, the potatoes creamy
buttery (thanks to spoonfuls of “fat spread”), and it was nice to enjoy a pie in
a place where desserts are not too common.
Today I get to enjoy another Thanksgiving favorite: leftovers!
This year is a very special
Thanksgiving. Being out of the country
and away from all the things I take for granted is difficult, but it gives me a
new perspective of all that I’ve been blessed with.
All of us at home really won the
birth lottery when we were born in the U.S.
We don’t have to worry about going hungry (in fact most of us are
overfed), while malnourishment is a big problem here.
We
have excellent healthcare at home, and
even those who can’t pay their bills are still provided care. Here, people have to pay part of their bill
upfront before receiving care, and they are not released from the hospital until
they can pay for the rest.
As I
mentioned earlier, diseases can go untreated if a patient can’t afford to
pay.
In the U.S. we go to sleep every
night in houses that are warm and secure.
In Mutomo, many people live in brick houses (they make their own bricks)
with dirt floors and a metal roof if you can afford it; otherwise it’s grass
roofing… and the houses aren’t snake-proof (we’ve had 3 snakebite patients this
week!).
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| Enjoying turkey with the neighbors. |
I may be living among the poor
and seeing their way of life, but I’m living in relative comfort here.
I’ll never know what it means to be truly
poor.
And so this Thanksgiving, I am
especially grateful for the privilege of being an American, to know that I have
a good home waiting for me when I return.
I’m grateful for my health, my education, a full stomach, clean drinking
water, and a warm bed at night.
And
though you are thousands of miles away, I’m grateful that I have family and
friends to share in life’s journey… and this year I am also blessed with new
friends in Africa.
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| Sorry for all the food pictures, but I have to show off my work. |
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| Anita holding the homemade pie! |
For all of life’s blessings, “Asante sana!”
(Thank you very much)
Happy Thanksgiving!
