01 June 2018

FAREWELL

     John is one of my patients with epilepsy and mild cognitive impairment.  One day he gave me ten shillings because he said that my work deserved payment.  He is 27 but his father always comes with him.  We smiled at each other.  I thanked John but told him that wasn't enough.  I knew that John made brooms and I told him I needed a broom.  He came through with TWO brooms this past week...to say goodbye to me.  Another patient with epilepsy, Koki, brought me a kikoy (traditional cloth from the coast).  She is 23 and always comes with her mother.  She too has some cognitive impairment but is happy and a bit overweight.  We've been working on decreasing that and she has been moving in the right direction.  This is why I choose family medicine.  I find such joy and satisfaction in the relationships I have with some of my patients.  And it is difficult to say goodbye.  The clinic was very busy and the clinical officer was not doing his job properly.  I have been working with him for several months and he is the person to continue on with what I have taught him.  I can only hope he improves.

     In another clinic they care very much.  An elderly man of 81 years, Mzee, was brought from his home 30 miles away by his son who lives a 100miles away.  Mzee was seen in the provincial hospital in July 2016 and hospitalized for abdominal pain.  They did a test for prostate cancer (PSA) which was 1421, extremely high. They wrote 'possible prostate cancer' on the discharge form which I saw.  They didn't tell the family anything.  This February 2018 he was admitted to the hospital at his home with abdominal swelling and severe swelling of both legs.  The oldest son was asked to sign a consent form for surgery.  They were told it was to repair a hernia but there was no procedure written on the form.  He signed a blank form!!!  The discharge summary documented that they took out both testicles to treat his prostate cancer and referred him to the palliative care unit where he received narcotics for pain relief.  All of this was necessary and appropriate but the family wasn't told anything.  He is an emaciated old man who can walk with a stick but was lying on his side in pain during the office visit.  His grandson was caring for him very well while I was talking to his son and daughter.  When I went to examine him I commented on how well the grandson was taking care of him and that he must love his grandfather very much.  The Mzee said he loved his grandson very much.  Then he said that he loved me very much!!!  

     Mzee is dying and I adjusted his pain medicines and other meds.  I also gave a referral form to the son so he can get morphine when he needs it.  But the most important thing I did was tell the family what was going on!!!  I was able to turn his care over to the staff at this hospital with confidence that he will get the treatment he needs to die peacefully.  However, I have heard that after the office visit he was so energized with better pain control that he is going out to work in his garden!

      On the 15th of May I went to Giriama dispensary despite a huge downpour and driving rain.  We did well until we had to turn off the main paved road onto the dirt road that would take us up the hill to the dispensary.  The gushing water had cut across the road and formed a deep trench.  We clunked down and stayed put.  My driver is used to driving taxis and I had to show him how to lock the wheels and put the car in 4WD.  Luckily, a bunch of young men were eager to assist by laying down some flat stones and help push the car. Of course we gave them a few bob which made their day and I was just so happy to be moving again.  This was the clinic that was renovated using contributions of over $15,000 given in memory of my nephew, Alex, who died tragically in an accident in 2013.  I wanted the people to know that love for him translated into love for them.  So I made a plaque and we placed it in the reception where his blue eyes,
blond hair and broad smile can look down on them  each day.  I'm sure that they will ask who he was and I hope they will hear the story of what love can do to make the lives of others better.
     I have now finished all the clinics that I have been doing in the Catholic Archdiocese of Mombasa.  It has been my privilege and joy to serve in East Africa since 1985.  I will use these last few weeks to turn over the work I've done to the Health Coordinator,  clean out the files, pack up my things and leave June 22nd.
     Once again Maryknoll Lay Missioners in Mombasa have moved on.  We welcome two new members, Kathy Flatoff and Mike Garr.  They bring experience in health care and project development along with a deep faith commitment and a lot of love.  They are living with me while they look for their own flats. I am helping to orient them to life in Mombasa.  And so it goes.  One leaves and two more arrive.  Our smiles show how we feel about our lives and ministries...very happy!
 

KATHY MIKE SUSAN CORALIS

PEACE OF A GRATEFUL HEART BE WITH YOU

   

01 May 2018

GIFT OF A WOVEN MAT (MKEKA)

Friday 13th April

     People often ask me to describe a typical day.  I can't.  I never know what will come up despite what I have planned.

     I am not a superstitious person.  But this Friday I did ask myself as I was getting ready to begin the day what might lie ahead.

    I was unusually organized and left the house on time to fuel the car and meet the driver at the usual place.  We headed to the ferry and met a jam stretching a couple of blocks down the road...very unusual at 8am in the morning.  I thanked God I had a driver to deal with the chaos and sent a message to the clinic that we would be late.  We had to cross the ferry and then drive 50 miles (80km) to get to Mrima dispensary near the Tanzanian border.  Along the way we hit a driving thunderstorm and couldn't see three feet in front of the car.  I again thanked God for the driver.  The trip usually takes two hours but this took three hours...actually not too bad I thought.  

     I walked into the clinic at 11am and found patients laying all over the benches and no staff in sight.  They were in the newly opened maternity unit next door delivering a baby and following a second woman in labor.  The clinical officer (physician assistant) came and told me that he had been up three nights in a row delivering babies.  He has no nurse/midwife.  Then he works the clinic during the day.  I told him to go home and take a break.  The only other staff was a lab technician and the receptionist who has no medical training.

     I slugged my way through the line of people waiting, one of whom was the mother of a young girl with epilepsy.  We have been ordering special medicine for her but I came to find out that she hasn't received it because it is still sitting on the shelf right next to the receptionist.  The receptionist is dispensing medicine and tries her best but when she can't find what I have written she tells the patient it isn't available.  The mother heard I was leaving and she made this beautiful woven mat to show her appreciation.

    By 2pm I was pretty hungry and asked the patients if I could take a ten minute break to eat a sandwich.  They were fine with that but after five minutes the receptionist was knocking on the door with an emergency...a 19 year old woman who had drunk kerosene in a fit of desperation.  She is the fifth wife of a wealthy old man and I'm sure she's not happy to be serving him and the other four wives.  Fortunately she was stable and although she smelled of kerosene I'm not sure how much actually went down her throat.  We sent her to the district hospital.

     Next was a 10 month old child who looked like a waif from a war zone and had severe pneumonia.  She was very malnourished and hadn't gained any weight in four months despite being on seven antibiotics.  I called the clinical officer to ask if anyone had thought about TB.  She was referred for a chest x-ray.

     The icing on the cake was a text message from my driver saying he had abdominal pain.  He came in looking very sick and promptly vomited up old blood.  Now I knew that I would be driving home!!!  I got him the meds that were available and finished up a few more details before leaving at 4:30pm.  I was behind the wheel and the driver slept most of the way home.  We got stuck in a big traffic jam due to demolitions of numerous buildings in the town with the ferry.  They plan to widen the road but at the moment it is filled with chaos and I was wishing I wasn't the driver!  Add to that another jam at the ferry and I didn't get home till 7:15pm when it was dark.  A 12 hour day most of which had nothing to do with my plan.

     I hauled the mat up to my bedroom and laid it out on the floor.  I will have two months to smile and remember the simple woman who was grateful for the treatment we were giving her daughter.  I couldn't have planned this so well!

30 April 2018 - Today I finished my last clinic at St. Patrick Dispensary in the informal settlement of Bangladesh.  The staff had a cake made to say goodbye to me and it was a lot of fun sharing it at the end of a long clinic day.  But the best part of the day was my encounter with Mary.  She is in her twenties and was orphaned when her parents died of HIV/AIDS many years ago.  She is skinny as a rail and we have been trying for years to get her tested to know if she is infected.  She's a bright girl who scored well and went to a prestigious high school but she can't get a job.  (Unemployment among young people is about 50%).  She has been volunteering at the clinic so she can get a small stipend for transport and lunch.  Now she has Chikingunya virus and came to work with a fever, tired and lots of joints pains.  She's so poor that she can't afford to miss this little bit of money for food.  So I took my last chance and asked her why she was so afraid to be tested to know if she is infected with HIV.  She said that she would feel terrible because it would mean that she was infected by her mother.  I talked about bad luck, a loving God who doesn't judge and about the problem being people who do judge.  She shouldn't let them make her feel bad. I told her that if she is positive that we have medicines to make her stronger and healthier.  In my desparation I told her I am sick too and have to take medicine four times a day. I thank God that there is medicine to help me live and help others. All the sudden she said OK.  I went quiet.  I asked her who she wanted to test her and when she told me she said she didn't want anyone else to know the result.  But the test came out negative and she was flying high.  I think everyone knew as we gave her the first piece of cake with the most icing and calories.  What a way to say goodbye to one of the best clinics we have in the Archdiocese of Mombasa!!!

HAPPY FEAST OF ST. JOSEPH THE WORKER

HAPPY MONTH OF MARY MOTHER OF JESUS

PEACE OF THE KNOWLEDGE THAT GOD LOVES US NO MATTER WHAT