1
Six weeks on Matungu jeep line
From the 8th of June till the 19th of July.
On Sunday the 8th of June I arrived by plain in Kisumu. The first thing to do was, to go to the shopping centre at the Nakumatt supermarket to buy a simcards and some food. The shop is full of items and it gives you a wrong impression when you come to work for the poor. One can buy there almost everything. Up country there are still many people, who can not imagine, what people can buy in such a shop.
Rotary doctors house in Mumias1
On Monday morning the 9th of July we departed a quarter past eight to the first clinic. Our team went to Kandai, more than 25 kilometer from Mumias.
The day started slowly. The first patients came late after ten o’clock and most of them came even after eleven. It was good for Hankees Smit, the earlier jeepdoctor,to explain everything and so that I can become used to how it works. For that it was a good place to start. We didn’t have to hurry.
The possibilities for lab examinations were very restricted. There was no test material for HIV that day. There was no reagent for stool examination, but a few days later this situation was better.
We finished early, at 14.00 hour. We saw 27 patients and than we got our lunch with white bread,tea and banana’s. Other days we got mostly ugali (cornflower porridge) withsukumawiki or chapatis. The doctors have to become used to these kinds of food.
After the lunch there was a small meeting with the local volunteers committee with the coordinator Jacintha Karimi. She asked the local committee to give more publicity for the clinic so people would know about the services.
Waiting room in Suwo 1
Tuesday the 10th of June was my first day alone, but it was easy for me. The way to work was almost the same like it was for the Dutch Rotary Doctors in Mundika two years ago. I understand already a lot of Kiswahili . So on the second day it was no problem for me to do the clinic alone. On the second day we saw 47 patients in Ebubambula. There were many patients with malaria. This would be the same during my whole period on the Matungu jeep line. Almost 1/3 of the patients were ill because of malaria. It is rain season.
On Wednesday we worked in Namasanda. On Thursday in Itete and on Friday in Suwo. Every day we could use local churches to see the patients. With curtains or the use of small rooms there was some privacy for the patients. I got support of good translators. They had after more than one year a lot of experience and could give therefore sometimes good hints about diagnosisor treatment of patients. We have to be very grateful for the support of these volunteers of the local committees. Without them it would be difficult to organise the clinics.
The patients choose themselves to come to the clinics of the Rotary Doctors. Only some patients are very ill. Many have malaria. We see a lot of patients with skin problems, especial fungus infections on the skull of children and many wounds on the legs of bigger children. Patients come with acute illnesses.They know for what kind of problems we can help them or for what kind of problems it is better to go straight to a hospital. With my experience of having been working in Tanzania in a hospital I saw much less complicated cases.
For several adults we are sometimes good for a second opinion or to get explanation about a condition for which they went already to a hospital, without getting good explanation for example patients with cancer.
Many patients are not able to explain, what kind of disease they have or what kind of treatment they got in the hospital. They got examination and treatment without hearing a diagnosis.
It is good for Rotary doctors to try to communicate well with the patients. We can be examples for good communication even when we don’t know the local language and have to work with translators. Good communication is the base for preventionof diseases and to prevent abuse of medicines!
A lot of things can easy be improved. Malaria can be foughtback by using bednetsand clotheswhich is covering the arms and legs in the evening.
Wounds can be prevented by teaching better disinfection of small wounds. Many big tropical ulcers start with infected insect bites or wounds by grass, which are itching. I thought many times that with a small bottle of Iodine this could have been prevented.
The same is with infected wounds of sandflees( jiggers). When people use footwear constant, the infections would be much less. Many children still walk barefoot at home or around the house.
feet infected with Jiggers
It was a good thing to be with two doctors in the same house. In the evening there are many things that can be discussed. But perhaps it can be more useful, that the doctors start alternating. The new doctors for the Mumiasjeepline and for the Matungujeepline start now at the same week. Perhaps it is better that the doctors come three weeks after each other.
One doctor is used already and the other doctor comes new after three weeks. Much information can be more useful on such a way. The doctors can learn more from each other.
I enjoyed it to be in Kenya. Happily we felt us safe in Western Kenya. We could daily read in the newspapers about the attacks by al Shabab at the coast, in the region around Lamu. But I was not worried like the local people. Since independence such things didn’t occur in Western Kenya.
It was a pity that the region in Western Kenya is so populated. There is not much nature anymore. On two Saturdays I walked with a friend of Evans, the watchman, around the town of Mumias. We walked to the river Nzoia and we went to see the parts in town were people with a higher income are living. Not everybody is poor.
After the six weeks in Mumias I used a local taxi driver to take me around to visit other parts of Kenya. This year we walked two days in the Cherangani Hills and we visited OlPetajaConservancy andSweetwatersChimpansee Sanctuary in Laikipia.
This is different from a visit to Masai Mara, where I saw many zebra’s and wildebeest, but less other animals. On the last day I made a visit to the Roman Catholic University in Nairobi. Then you forget almost, that we were in a developing country. I saw the medical clinic for the students. It was as wellequipped as the clinic of a general physician in the Netherlands. Only there in Nairobi comes only twice a week a doctor.
I enjoyed to be seven weeks in Kenya combining the volunteer work for Rotary and to have one week holidays. It has given the feeling to do it another time again. I can advice it to colleagues, who have not yet been in Africa. It makes you grateful for all good things we have here. You will not forget it!
August 2nd 2014
Gerard Haverkamp