Friday, October 8, 2010

Our Day Off - Kakamega Rain Forest & more!







Oct 8, Friday








We left the OR at 2:00 AM!!!!!! So so very tired. Our last patient was a 14 yr old girl with severe facial burns who needed quite a bit of reconstruction and grafting.








Due to the fact that our 9 month old burned pt. did not have lab work we had today off. I slept under my net until 12:30!! I must be beginning to feel a bit more comfortable because the bedding actually looked like someone slept in it.








I put on my flip flops, trying not to look around in the shower for any crawling things and freshened up.








The ambulance was waiting for us...our means of transportation, and we were off to the Kakamega Rain Forest. If you have any interest their web is...rondoretreat.com








It was a ride that was filled with adventure as well as the day. The roads are red packed dirt with huge bumps and holes that a 30 min rides takes an hour and a half. The drivers a so accustomed to the roads that they ride in a zig zag and off road. It is nuts. We hit a major storm on the way and a couple of us had to move our seat as the ambulance leaks. Mind you, this vehicle has a 7 inch wooden bench on one side and a cushioned bench style seat on the other and behind the driver 2 can sit. I was on the 7" wood holding onto a metal bar from the ceiling. The windows are covered with pealing gray paint so viewing is limited unless the sliding windows are open. I was just into the whole experience of it, there I was in the middle of absolutely nowhere, in a beat up ambulance, in a torrential down pour, in probably one of the poorest places in the world, with 5 others and loving every second of it.








Our guild, Wycliffe, was great. He took us on a wonderful hike through the forest and up a huge mountain. Glad I did so much riding this summer, it came in handy. He pointed out 4 varieties of monkeys, several plant species, trees, birds etc.








Back at Bishop Stam guest house for dinner- 9:30. We had a bit of a problem with the return from the forest but it finally worked out. Willi was there waiting with her amazing smile and served us.








After dinner I went in the kitchen and helped up clean up as the others went to their rooms. Well, Willie had a treat for me. After we put everything away, she said come in the back I have to take the feathers off the chickens and prepare them before I go to my room. ( huh?) Don't ask!!! This was just too much ...So, we go in the back of the building and there were these freshly killed chickens being defeathered. Then Willie places them on open coals and constantly flips them ( quick roast?) We go into the kitchen where she proceeds to gut them. Yep!! Takes the intestines,gizzards and other insides- out. Takes the 2 chickens and lays them in a freezer. I ask her if she wants to put them in bags. "No they will be fine, " Willie says.








What a day!!!! A real African adventure.........................








Thursday, October 7, 2010

Life Changing For One






















Our first case of the day was an 18 year old girl who has had to live with a cleft lip her whole life. She said she was not allowed to greet people in her home and her parents were ashamed of her. She never laughed.




I made sure I had a mirror for her to see the results when the surgery was over. She had local anesthesia due to the fact that she was pregnant. Post op she said she was grateful for the team and is so happy.




Inserted some photos beautiful African people.....

Oh What A Day!







My mission today was to administrate...get more cases. We were running out of patients. When we arrived at 8:00 AM I went to Dr. Daniel Alushula's office and talk with him about this situation as the team sets up for the surgical day. I was given a driver and a nursing student as my interpreter for a 2 hour drive to the Nyanza Provincial General Hospital, in Kisumu. I spoke with the coordinator for Operation Smile and one of their surgeons from the Netherlands. They could not help me. I did not want to leave without giving it my all so I went the hospitals director Dr. Juliana Otieno. I left a bit disappointed but quite educated in this process. I made some great connections, maybe my Thomas Jefferson Mission group will one day come to fruition!!


I asked my two travelers where we could grab lunch...I truly believe their experience with restaurants have been minimal.


Pulling off a dirt road at the first place we stopped, I asked if we could find another one as my stomach is not as tolerant as theirs yet. Let me tell you, where we stopped you would have been in shock!


There was a MALL!!!! In the middle of dirt roads! Well, not a mall like we know, but a mall with a real restaurant. Africans customarily eat with their hands so the waitress came around with a pitcher and basin pour water over your hands and you wash before and after at the table. Quite a nice custom.


I observe people rarely smoke in public. I have seen one person in 4 days.
I went to a hospital in service ( CEU ) the topic was, Corruption all doctors must attend. It is a big problem here.
One quick note that is just so bizarre is comical....there is a big deal made of all people entering the 'theater' to change their shoes. You choose a pair of plastic white boots or clogs that have been cleaned with Clorox. The 'theaters' are so dirty and old that the shoes are really the least of their concerns but it seems to be paramount!
Well, last night as I was about to but my sneakers on there was a roach the size of what appeared to me, a small child! I started screaming for Margaret, the night nurse who was up to her thighs in Clorox. With her beautiful accent she says, " I will just take it with my hand." I was flipping.. She started laughing that the tears were flowing from her eyes. Don't ask!!!
Needless to say, I am NOT changing my shoes again!!!!
We were out by 10:30 PM.

Wednesday, October 6, 2010

AND SO IT BEGINS

Saturday Oct 1/ 2, 2010

Flight from Philly to Detroit was uneventful.

Before the sleep aid….I laughed my way ½ way across the Atlantic watching Joan Rivers get roasted and The Informant. Thanks Jared.

Met Mary Lee in Amsterdam 2 hours after I landed. She is a hoot from N. Carolina. A physician’s assistant who works for a plastic surgeon. At the gate for our final flight to Nairobi and I was stopped to check my bag…nope, I talked my way out of that some how. It was a 747! The bins are huge…After I was seated on the plane I realized I left my fleece where Mary and I had coffee. I was bummed, but o’well.

Arrived in Nairobi at 7:30 pm pretty tired. We found our way to the visa line then found the exit. I spot a familiar face holding a sign, ‘Maxine & Mary,” Dr Geoff Williams, Majog Judith, an anesthesiologist, Jenny 23 an RN and Flor also an RN or has worked w him for 3yrs, were waiting for us.

We all get into a van and stop at a market, to pick up a few things. I grabbed a couple of bananas, water bottles, and granola bars. Mary and I share a room. Well, it was pretty basic to say the least. When I saw the mosquito nets hanging and Mary told me she saw a flea in her bed I was skeeved! Mary told me to apply deet on before I go to sleep, really? So I did. Wore long sleeves, pants and socks to bed and didn’t pull the bed spread down. Got under the net, Mary said,” don’t let the net touch you.” Placing shoes on the corners to kept the net raised I didn’t move a muscle for the 5 hours until we had to get up to catch the plane to Kisumu.

Showered, grateful I remembered to bring my flip flops and rushed to meet up with the group at 6:30am. All the bags fit and we were off to JKIA for our 8:00 flight to Kisumu. We were picked up by a beat up 1970’s ambulance and a car. I chose to ride in the car. The bumpiest ride with pot holes the size of craters that the car had to dive off rode. The 2 hour ride provided me my first real views of Kenya and its people. Many women walking with jugs and other types of items for daily life being carried on their heads, bike riders, kids without shoes, big markets with bright colored clothes. Houses made of mud with tin roofs and cows and chickens milling around. We pulled over so the drivers could show us the Crying Stone. Four small boys all brothers, crossed the street to check us out. The eldest was 11 and told us the story his grandfather told him about the Crying Stone. It was magical.

We arrive at the Bishop Nicholas Stam Pastoral & Animation Center, Diocese of Kakamega guest house . We all had our own rooms that were adequate, ( I use this word loosely ) with a mosquito net. It is an oasis behind huge gates in the middle of complete poverty. ($22 / night ) The facility is huge with conference rooms, chapels, 160 can board, multi purpose halls….lush greenery and scary dogs that howl in the night that I thought there were coyotes.

Off to the Provincial General Hospital to meet the director . We sat in a room set up to be a board room. I us the word board room very very loosely. Had our initial welcome and intros, saw the patients for tomorrow and gave the children stuffed animals and dolls.

Dinner was a blur but I was conscious enough to stick to the veggies.. I can’t bring myself to eat any meat served as I see the chickens and emaciated cows on the streets. I have tried some interesting vegetables, ugali ( maze meal w water – white ball ) sukuma wiki ( green veg

Mom called after I was a snug as a bug in my net! It was pitch black in my room; the phone was charging and hanging from an outlet in the bathroom. I nearly strangled in the net as I didn’t want to miss the call, you see the mosquito net hangs from the ceiling and drapes all around the bed to the floor! I had to use tape to patch the holes in the net….all I kept thinking was I would wake up and there would be little critters stuck to the tape!!

Monday Oct 4, 2010

Ahhhhh migraine at 4:30 am…took my meds and by the time my alarm went off at 6:15 I was my old self. I finally felt on the correct time zone. It took almost 2 days. Breakfast at 7:00 and Willie was there smiling with a beautiful table set. I asked her for coffee expecting rich Kenyan coffee like Starbucks only to get a pot of boiling water and instant Nescafe- Columbian.

I was so charged for our first day. I was assigned the recovery room. I was actually happy with that as Flor mentioned he has gotten slower and a cleft lip is now about 3 hrs. We didn’t get started until 12:00. Well I really shouldn’t say we. Since the USB wi-fi was not working I went into the town and tried to get that fixed. Justice, a porter, and I couldn’t find my driver he suggested we go by motor cycle, I declined. He found another driver and off we went. There I was the only and I mean the only white female for miles and I did not feel it for one second.

How do they do it? Bananas in large baskets, sugar cane 4 feet long 15 at a time, 100 lb bags of four on their head!!!

The most memorable part of this day was when I showed my first patient, Faith, who is 7 yrs old, her repaired cleft lip in a mirror……this is why I am in Kenya.

Left the OR at 11:00 PM…long day…no dinner

Tues. Oct 5

Mary Lee knocked at 6:45 and we were the first to see Willie. I helped her get the breakfast things to the table. I followed her out back and was stunned by the primitive thatched 3 sided wooden structure with 2 large pots over hot coals containing boiling water and milk. Willie proceeded to dip a pitcher into theses pots and pour the liquids into the thermos.

We had 3 cases on the schedule. I scrubbed for the first cleft lip. ( 3 hrs ) I broke scrub ¾ into it talk to the director, Daniel Alushula MD, about getting more pts. It looks promising.

left the OR at 12:00 dinner was waiting in our lounge! wiped out!!!

Wednesday, September 29, 2010

Dry Run

....The carry on, will it fit in the overhead? I packed it last night and kept looking at it. It looked questionable, so I asked my son, Jared, to accompany me for a drive to the airport. He said in more than a few words that I was crazy.

This soft bag weighed about 40 lbs as I schlepped first to the initial check point inside the departure area. I asked a Delta rep and she said as she pointed to a sign with a metal rectangular shaped opening, place your bag in there. It was like trying to place Cinderella's slipper on the step sister's foot. I went up to the security area and spoke with, "Hazel." She advised me to unpack a few things and layer. Hazel said if she is at security when I go through she will let me go but there is another woman not as nice.

I have repacked 2 more times deleting more and more. I am down to 33 lbs and a bag that looks like it will fit. I would love to check a bag but with all the flights I am not sure it would actually arrive in Nairobi when I did. I can't believe I am going away for 3 week with a carry on!

Wednesday, August 25, 2010

Thomas Jefferson Travel Medicine Services

IF, yes IF, I was a "normal " person traveling to Africa and had spent the 2 hours with Dr. Marilyn Bradford at TJUH travel medicine sevices as I did, my trip would have been cancelled.

I am one who declines the flu shot each year, yeah yeah yeah, I know! No, I have not gotten the flu....yet.

The plan was to get the yellow fever vaccine and the malaria prophylaxis, done. I was going to get the tetanus at my primary Dr office later this month. Well, between the newspaper articles and the pictures of Kenyan people dragging their legs due to polio I opted for the booster..Then we moved on to contaminated food and water- yep, typhoid vaccine!! That one's oral, it was pretty funny as she gives me 2 stickers, one for the frig and one the bathroom mirror and then a bright orange rubber bracelet ( livstrong-type) as major reminders as it's an every other day capsule for 7 days.

Then Dr. B touches on Leishmaniasis disease. Acquired by a bite of an infected sand fly. Dengue fever a viral infection spread by the bite of the female Aedes mosquitoes. Then she continued on with the typical traveler's diarrhea, what to avoid, safety tips and what to take in my medicine kit. She was extremely informative. I asked her if she travels a lot. She answers, " no, my husband won't get on a plane!" Pretty ironic.

Monday, August 23, 2010

Facts

Africa, the planet's 2nd largest continent, includes (53) individual countries. It contains the Nile River, the world's longest, and the massive Sahara Desert, the world's largest. The continent's (highest point) is Mt. Kilimanjaro, in Tanzania, 19, 341ft (5, 895m), while the (lowest point) is Lac' Assal in the small country of Djibouti, 512 ft (156m) below sea level.

Friday, August 13, 2010

Friday the 13th - August, 2010

After days of research and speaking with various airline reps I decided today was the day to purchase my ticket with Ray, the rep from International Travel Network. I am booked!!! I really am going to Kenya....

Oct 1- Philly- 12:35pm arrive Detroit- 2:23
Detroit -4:10 arrive Amsterdam -5:55am ( Oct 2)
Oct 2 Amsterdam -10:25am Nairobi - 7:25 pm

Oct 3 Nairobi to Kisumu to Kakamega for a 6 day plastic surgery mission at the Bishop General Hospital. The typical day as the surgeon has informed is, arrive at the hospital at 8 AM and leave around 9 PM, 3 cases per day, from 2.5 - 3 hrs per case.