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

It's been a while

It’s been a while I apologize. I have some good pictures from Lodwar and Mombasa in no particular order, so enjoy. I’ve been trying to keep myself really busy working around the hospital in Migori. Right now I’m trying to put together a medical supplies shipment here through the charity Project Cure. I’ve worked with them for some time, it’s a great organization. They send supplies around the world to places in need and without being coy, this location defiantly qualifies. Some blaring example include at times the hospital doesn’t have any oxygen because there are no oxygen tanks, or masks that fit patients. Other times surgery has to be cancelled because there are no surgical blades or propane to heat the fluids. The lack of resources gives one a real perspective on the difficulty of life in destitute poverty.

Anyway the process is moving along but there’s a lot of red tape trying to figure out customs and shipping details. One thing you learn in Kenya is that the bureaucracy here is quite frustrating, but then again I suppose the opposite would actually be strange.

I’ll be home in about a month and I’m looking forward to it. I could really use a day of skiing, life on the equator is a tad hot. I miss everyone and I hope all is well.    

A slab in the road in Mombasa

A man in Kakuma, trying to retrieve water from the ground.

An image from Lodwar "airstrip", Just two jet engines from a striped plane

The terminal at Lodwar airstrip. Quite the security, a single unlocked gate

A view of Mombasa

The main road in Mombasa, the tusks are the symbol of the city

The old town of Mombasa

Return

The gate to the staff compound.

The town of Lodwar. the single town within hundreds of km of the camp and where my plane landed. It reminded me of the bandit town in the desert of the first star wars, as brutally nerdy as that is.

The landscape

Some of the rare homes of the locals, the Turkana.

the furthest edge of the camp, it extended down the road 10km

Some refugee housing

Inside the compound, staging area for the staff and to distribute materials.

An odd sight, the river of the area just without water. It's that hot and dry here.

The landing strip of the camp.

Typical housing, huts made of plastic sheets from the U.N.

The best picture I've taken so far. A view of the evening soccer matches.

I'm back from the camp, earlier than intended for a variety of reasons. If you watch the news Kenya's war with the Somali terrorist group, Al-Shabaab made life at the camp difficult and possibly much shorter. Alot happened, most of it bad but some good. If you want to hear everything we'll have to sit down for a drink. I guess a picture is worth a thousand words so I'll let these do most of the talking.

Leaving For Camp

Tomorrow I leave Migori for Kakuma refugee camp in northern Kenya. I originally was meant to go to Dadaab however due to security I was transferred to Kakuma. I will be staying there for 3 weeks and will be working with the WHO on treating malnutrition and malaria. This camp is very secluded so communication for the next couple weeks will be difficult so please bear with me if you need to contact me. I have a phone now for emergencies so if anyone needs to contact me I can be reached at +254 706 365 737. I ironically have been reading the book "What is the What" by Dave Eggars, about a Sudanese lost boy who lands in Kakuma for 5 years. The book is amazing and if you want a look at what life is like there, it's a great place to go. I miss everyone. This will be very hard and it makes me a little nervous but I'm excited to help where I can, even if its small amount. 

Few Photos

 

The local barber shop

A burned down building just a ways down the road from my house.

This is the entrance to the hospital. The sign I think is funny because during a funeral people crowd the entrance and sing, cry, yell, hoot I guess you would call it. It's a really large event and no one gives a crap about the sign.

The van on the right is a Matatu which is the basic private bus system here. The drivers are insane and bribe the police to let traffic violations occur, like this gentleman allowing a couple guys to just hang off the side. Also notice traffic etiquette doesn't really apply here, you pass when and where you want.

This is a view of Kisii.

A couple kids walking in the no mans land between Kenya and Tanzania i.e. It's not very well patrolled

This is almost like a grill on the side of the road. People here just set up fires everywhere and sell cooked food almost anywhere.

Most shops and towns look exactly like this.

A soccer team getting warmed up. they were practicing meters from the Tanzanian border. I just thought that was an odd place to put a practice field. caption

The Tanzanian flag right as you enter the country.

This is my favorite. The sign saying you've entered Tanzania, but it's almost comically overrun by advertisements you barely know it's there.

This week at the hospital has been a nice return since being sick. I’ve been training in the medical ward now and have learned a great deal about malaria. Getting it certainly helped the learning process, as unfortunate as that was. I’ll have some really good pictures of cases soon, I feel bad taking photos of patients but I’ve made some friends who have agreed to it. I’ve also started a good amount of training on extreme malnutrition management which will be very helpful when I leave for the refugee camp later this month.

These pictures aren’t really hospital related but are really cool glimpse of the area. Some are of the town of Migori, some of major city about an hour from Migori called Kisi (We travel there occasionally for supplies). Finally some are of the Tanzanian border, I traveled there one afternoon basically on a whim, and to add another country to the list.

Malaria Time

The ambulance here, and my ride after dark. Whenever I'm called for an emergency at night the really friendly driver picks me up. I'm not allowed to walk anywhere after dark even the 100m to the hospital for two reasons, the people and the huge wild dogs that run the streets at night.

A tranquil view from my back porch of my laundry hanging.

The upper level of the hospital, this building is outpatient/observation, the eye clinic and the minor theater which is equivalent to a smaller O.R.

Lauren with Malaria. A very dramatic pose. I was jealous because they gave her the mac daddy sweet and I got stuck in pediatrics.

Exiting the hospital

Inside the wards. The hospital is very different here in that it is very open air.

In an ironic twist this week I was diagnosed with Malaria on Tuesday and have been trying to get over that all week. This was the sickest I’ve ever been and while sparing the gruesome details it mostly involved a lot of trips to the bathroom involving both ends.

Theweek began with a bad omen when Lauren actually got malaria as well, seemingly setting the stage for myself. And before anyone asks, yes we were taking our pills, sleeping under a bed net and taking all the precautions. I really have no idea how we got it. Our current most popular theory is that while at Masai a Marra we were bitten by mosquitoes with malaria strains resistant to our prophylaxis since the disease takes about a week to become symptomatic. We pulled that out of nowhere but really who knows.

Our treatment really began with a lot of fluids since we were very dehydrated followed by I.V. quinine. Fun fact quinine is the exact same ingredient in tonic water so a local remedy for malaria here is drinking a lot of tonic water. We both spent a night in the hospital and learned quite a deal about what the experience is for the patients here. Let’s just say luxury is not an adjective that comes to mind. Being ill also made me very homesick. I missed everyone back home very much this week. 

Sorry I’m light on photos this week, these are really just a tour of the hospital oddly enough as I was visiting Lauren just hours before I went down.