Into the slum we go!

Nairobi Travel Blog

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Well today was the first day of our program.  I got up feeling dead tired, made my way down to for my piece of bread with watery jam and really smooth peanut butter, expecting to leave in about and hour.  Then in comes Boniface from Fadihili Community, informing us that he is here to walk us to our placement.  Well, I was pretty much ready but Nan needed some time.  After we waited a while and gave her some friendly jeering, we said goodbye to Leslie and Sarah, who were heading to their assignment two hours away, and made our way towards WEMA Clinic.  We walked about thirty to forty minutes through Kawangware slum as all the kids shouted mzungu (foreigner) and ask “how are you?” Always trying to be the friendly white guy I simply replied “feet”(slang: I’m well) and asked “sa-sa” (slang: how are you?).   When we first arrived at WEMA and saw the waiting room I thought this isn’t too bad, but then Boniface took us around back to wait in Dr. George’s office.  As we walked along the side of the building towards the back of the clinic I looked at the ground and saw several discarded glass medicine containers on the ground.  Behind the building was an open yard where people were washing their clothes and drying them.  We finally pulled around to Dr. George’s office.  The place was so cramped with shelves of medicines, documents and Dr. George’s desk, that two people could not pass without both turning to the side.  The room smelled like diabetic urine.   We waited about ten minutes until Dr. George finally arrived.  He’s a nice guy, about mid thirties, nothing but smiles, and welcomed us to the program and to Kenya.  He asked Nan and me if we had any medical training?  We were both pre-medical graduates and had some experience in clinics.  We then met Jenny, a nurse from England who was here for the last month.  Dr George said Jenny would show us around and give us some idea of what we would be doing.  Jenny had to change the dressing on a toddler who had been dropped in boiling hot water and had third degree burns on her left arm and leg, and all around her midsection from just below her left arm pit to her lower thighs.  It was a pretty tough and gruesome site to see, but I felt good that I desperately wanted to do what I could to help.  It was also difficult to see the child held by her mother, who, from what I could gather, was the one responsible for dropping the child in the boiling hot water.  In the states that woman would be in jail and the child in protective services, but there is nothing like that in Kenya.  At least the wounds looked like they were healing well, but that child will have scaring all over her body for the rest of her life.  The tactics for dressing the wound was really unsanitary.  Soiled and bloodies gauze was placed on beds in which patients were sleeping, thrown it open, mesh waste baskets, and the patient was placed back in a bed that hasn’t been changed in several days.  After the dressing, Jenny explained how there was no real instruction just needed to do what you can where your needed.  She showed us how to make some antibiotic mixtures that Dr. George liked to use.  All around there were broken medical bottles and shards of glass on the counters, by the sink and on the floor.  I was stunned by the degree in which the Kenyan nurses, and Jenny herself, were unphased and could continue on providing healthcare in such hazardous conditions.  Work place safety quickly became my passion for the day.  I was constantly stuck in thought on how I could cheaply and efficiently control sharps.  Even syringes were just thrown in an open garbage can.  Jenny told me that it was not unusual for goats to come around and eat the discarded glass shards.  Dr. George came out of his office and asked Jenny to inform a woman that she was HIV positive and if anyone wanted to observe, they could.  We all agreed that only a girl should go, so Abby, another recent volunteer from Michigan, and Jenny went and talked to the woman, while Nan and I hung out.  Shortly after this, Dr. George came and asked Nan and me to chat with a man who had been hit by a matatu (Kenyan van cab) and had suffered massive cranial damage.  Dr. George just wanted us to keep the man busy while he waited for Jenny to finish delivering the news to the HIV Positive woman.  The man told us how he had been knocked unconscious by the matatu for ten days.  The matatu took him to the hospital, he was quickly transferred to another hospital where he received some pretty rough facial surgery where he lost four upper and four lower teeth, (two incisors, his canines and a molar on both) and had his face stitched back together.  The stitching of his upper lip left a large raised section.  Jenny has been writing surgeons all around Kenya but no one has wanted to help.  The whole interaction was sad, but actually very enjoyable.  You could tell the man got some sort of catharsis from telling his story and it was really an honor to hear him tell it so comfortably.  Finally, Jenny finished with the other woman (which apparently went nowhere, the woman is mentally ill, has little education, and neither Jenny or Abby felt the woman understood what she was being told) and came to check on the man’s wounds.   After this point, there wasn’t really much going on.  Jenny and this other American, John, a recent med school graduate, were redressing a scrotal hernia, which I tried to get in on but the door was locked.  Nan and sat down for a second outside, and found a discarded scalpel blade on the ground.  I picked that up and threw it away before the goats, whom had just wandered in, could make a meal of it.  All of this helped me refocus on creating sharps containers for the clinic.  Meanwhile, Abby held a girls foot as a nurse removed the dermis on one of her toes with out any antiseptic.  None of us can figure out why, but they did.  Afterwards, we decided the best way we could spend our efforts was to create a pamphlet on HIV for the clinic and work on generating ideas for sharps containers and perhaps changing linens more frequently.  We went to lunch, worked on our project, tried to get some info off the internet but the signal was terrible, and then headed home.  Nan and I stopped at a real internet café where the signal is tolerable sent some emails and again headed home.  By this time the sun had just set and as we stepped out of the internet café, Rachel, the woman who we are staying with and owns the beauty salon next door, asked me to carry a wad of money home and make sure no one sees it.  She didn’t tell me, but I assume after dark it is risky for anyone, including people working in stores, to gather large amounts of money from fear of being robbed.  So Nan and I, somewhat anxiously, made our way home back to Rachel’s.  Once home I took a shower, hung out with Lucy from Aus for a while, helped Eddie, Rachel’s 17 year old son, reroute the antenna signal to his Mother’s room, then Sarah made dinner.  After dinner Eddie, informed me I needed to help him pour large buckets of water from the tap outside into a large cistern.  This seemed weird because there was a larger cistern right next to it, which I had been told at some previous time, received its water from the city, but I just did what I was told. After we finished one round of water pouring, we headed to the corner store to because my room needed a light bulb and I wanted to buy some eggs.  As we walked I asked Eddie why we needed to fill the large basin.  He explained to me that city is rationing and today was the day that our part of the city received water.  After tomorrow the water would be turned off for the week until next Monday.  Therefore, we get as much water as we can just to make sure we have enough for the week.  In fact, this is the longest series of consecutive weeks that the water has been regularly turned on.  He there was a time where his family when two months between city water. Once we made it home we put my eggs in the egg rack, complete with chicken remnants, including one feather stuck to the egg with, what I can only assume is feces.  We then watched some TV.  Eddie turned it to Style TV, which was showing “Kimora Simmons: Life in the Fab Lane.”  Well needless to say, after the day I had of seeing people being medically treated under the conditions of the WEMA clinic, I couldn’t help but squirm with every car she cherished, every frivolous perk she took pleasure in, and every liberty she used in searching for her new home in Beverly Hills (such as searching for a home by helicopter).  I then had a tough time trying to defend the policies of the United States that permit such self-absorbed squandering of money possible to Eddie.   I did my best but I don’t think he really bought it.  We then went and emptied another round of water jugs into the cistern.  Afterwards I showed Eddie a map of the United States and gave him a brief geography/history lesson on the USA.  He seemed to really enjoy it.  Next Eddie and I watched a show on juvenile prisons.  Eddied gave me a long lecture on how good American prisoners have it.  “They live better than Kenyans.”  He couldn’t believe the resources U.S. prisoners got. Counseling, doctors, education…”I saw in one episode, prisoners were getting hot meals with MEAT!! In Kenya you go to jail, you die.  You might get some grain and water and a leaf of cabbage.  And in America you have jail for kids.  In Kenya, you go to jail with everyone else.”  It was a pretty interesting lecture, but it was getting late and I was trying to finish my journal entry (which you can tell was getting rather long) so I didn’t hear it all.  After he was done, we went outside, filled the cistern. I finished my blog and now I am going to bed.

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photo by: easyjobrob