Last Week

It's an odd time for me. I have only a week remaining here, difficult to believe. Thinking back now it feels more like years. I can remember when I first arrived just how differently I viewed all of Kenya, it seemed so foreign. Now really I think of it as a second home. I've made so many close friends that I really appreciate, time here would be difficult without them.

Random pictures of myself, second with my friend Tobias. Here were at Lake Victoria.

Recently my time has been occupied with a large public health project at the hospital. So here in
this part of Kenya I think around 50-60% of people are unemployed and live on around a dollar a day. That said their health really suffers. The hospital here does their best but payment and funding is a huge issue that they have dealt with for years. The hospital is in financial crisis and patients are really suffering because they avoid treatment b/c they can't pay and when they do come they are often in end stage untreatable conditions. Had they arrived early treatment is
simple and easy, the whole situation is awful and criminal to a point. Right now the hospital has a long standing policy of something called "discharge in", where they hold the patient hostage until the end of the year when the bishop comes and pardons their bill. It sucks, it costs money but worse off I think It could be argued as inhumane, patients are exposed to Tb constantly and most are immunosuppressed.

So for the last 2 months I've been assessing the hospital it's material needs to be funded by project cure but also I'm organizing a restructure of their whole billing and discharge in system. I came up with it with my good friend the anesthetist here, Alice. She is one of my favorite people in the world. Her and her daughter Lucy are my second family. Anyway the idea is for the hospital to pay for all discharge in patients national insurance called N.H.I.F. with that all in patient is covered, no more discharge in, no more financial crisis but best of all if it grows big enough all people in the community will get good coverage and unnecessary morbidity and mortality would drop significantly. Anyway putting it in place takes a lot, a ton of meetings, setting sponsorship up in the U.S. plus I still help treat and see patients all day long so I guess I'm burning it at both ends.

Hopefully I can tie all the loose ends by this Friday. I'm excited to come home and see everyone

All the best.

Pete