03 July 2013

     I left for a medical trip on 30th June and just got back home yesterday.  I see that 7 people have already looked to see if I'd written something new for this month so sorry for being a bit late!
     TheKenyan papers have had some interesting health statistics recently:
1. The number of people newly infected by the HIV virus has decreased by 40% in the last 5 years.
One third of these infections are in prostitutes, homosexuals and fishermen.  44% occur in steady partners as they trust one another and don't use condoms.  Five years ago only 36% of those infected knew they had the virus.  Now 70% know as more people are getting tested.
2. The number of new HIV infections in children has been reduced by 50%.  More pregnant HIV positive women are receiving drugs and the number of children on treatment in Kenya has doubled but still only 3 out of 10 children receive the treatment they need.
3. Multidrug resistent TB has risen from 255 people last year to 600 this year.  Mombasa has the highest number of TB cases in Kenya because of 'rasping poverty levels'.  Kenya is ranked 15 amonth the 22 countries with the highest TB cases.
     The little boy that I put on thyroid medicine at the end of May came back 19 days later and was already starting to sit up better, smile and vocalize more.  His mother sees good improvement and we are hopeful that he will make good progress quickly.  These children can have intellectual impairment so it will take time for us to see how much damage was done before we got him on treatment.
     A two year old child came to the clinic in Bangaladesh with blindness.  He had been diagnosed to have retinoblastoma (cancer of the retina) at one year of age in Kenytta National Hospital.  The mother is a high school teacher and she has already lost two of four other children.  The doctors couldn't agree on whether to remove one or both eyes.  The mother, in her fear and paralysis, did nothing for one whole year.  Finally her sister coaxed her to come see me.  We got a CT scan which showed there were masses in both eyes but they hadn't spread to the brain.  So, I contacted a  British opthalmologist who has a charitable clinic on south coast and she has a specialist visiting next week who will see the child.  They think he has Primary persistent hyperplastic vitreous (PPHV) a noncancerous growth that I've never even heard of!!!  This specialist will see him for US$3.00.
     The day before yesterday I saw two patients in the same clinic with advanced cancer.  The 47 year old man had lung cancer spread to his liver and hip.  The 57 year old woman had abdominal cancer of unknown origin which had spread to the lymph system and other sites.  Both of these people were in great pain and weren't taking any pain medication.  The usual scenario is for the doctor to say he can't do anything else.  The patients and their families then travel around from place to place looking for treatment.  The woman had just come back from a hospital in Tanzania.  There is so much work to be done on educating everyone about palliative care and good pain managment.
     President Obama bypassed Kenya on his African tour and that was probably a wise decision.  The government here still has some very serious allegations to answer for.  Today I read an article in the Daily Nation newspaper graphically describing atrocities that men have admitted to committing on Mt. Elgon in 2008.  These people fled to Kiminini where I was working at the time and I heard their stories myself.  I'm glad that finally the truth is starting to come out.  Peole have lived with some very heavy burdens and they deserve to be heard and find some restorative justice.
     While all of you in the northern hemisphere are enjoying summer it is winter here.  The temperatures get up to a high of only 80F = 27C and it's easier to sleep during the cooler nights.  The new moon will appear on the 9th or 10th of July and with it the beginning of the Holy Month of Ramadhan for our Muslim neighbors.  At least their fasting will be during the cooler season this year.  Tomorrow will be the 4th of July and we from the United States are very blessed and have a lot to be grateful for.  But it would be good for us to humbly admit that we still have things we can do better.  Let us see ourselves as part of a much bigger world and committ ourselves to making life better for everyone with special attention to those most in need...with liberty and justice for all.

01 June 13

Happy Madaraka Day!!!  Today is the 50th anniversary of self governance and freedom of speech for the country of Kenya.  In 1963 the British turned over responsibility (madaraka) to the Kenyan people on this day.  On 12th December they will celebrate complete Independence...the day the British flag came down.  This picture is of the people from our 19 health units who attend a meeting together every four months.  I salute them and all the health workers of the Archdiocese of Mombasa who try to provide good quality health services to all, especially those in need.
Kenya still has its struggles.  On 28th May there was no electricity in the entire nation for five hours.  The clinic I worked in on Friday was without electricity for two whole days.  On Thursday the national hospital of 2000 patients in Nairobi had to stop doing surgery because they had no water!  The exact reasons for these problems are not entirely clear.  But if we are clever we can find a way around some of them.
     In April a mother, Asha, brought her one year old son, Seif, for two days of diarrhea.  This is her first child and she and her husband are doing their best.  But the child had been losing weight for 6 months and now weighed only 12 pounds.  Despite bringing the child to be weighed every month no one had done anything about his failure to gain weight. His muscles were so weak he could hardly sit up and he couldn't stand at all. I was concerned about several serious problems and referred the child to a pediatrician at the provincial hospital.  The first time she took him the doctor wasn't there.  The second time the doctor was in but had no time to see him.  The third time I'm not sure exactly who saw the child but they told the mother that she had to go to a private hospital with 4000 shillings ($50) for lab tests because the lab couldn't do them at the government hospital.  So ,she trusted me enough to get in my car and we went to a lab that I know does good work and I spent 1240 shillings ($16) to do one test that gave me the answer...the child has low thyroid hormone.  I thank the pathologist who gave me a 10% discount on his charges.  On Friday we began giving him thyroid hormone and hopefully he will start improving.  And I thank each of you who contribute to our ministry so I can find a way around some of these challenges!
     I will try to make an entry to this blog on the first of each month. We lay missioners in Kenya have also committed ourselves to focus on peace on the first day of each month through our prayers and our actions. So when I go to Mass this evening I will not only be praying for the people of Kenya who are celebrating their freedom but especially for continued peace...despite the continuing challenges!

22 May 2013

Full moon over Indian Ocean Mombasa

     This beautiful picture of the full moon was taken by Mary Oldham on her last night in Mombasa one month ago.  It has been a month full of rain and new growth in the fields.  I also have a wonderful story to share.
     Many years ago when I worked in Kitale, Kenya Russ Brine, another Maryknoll Lay Missioner, came to our hospital with a request.  He overseas the Bosco program for rescuing children from the streets and he had a boy named Ben who wanted to be a doctor.  Ben was from Turkana, north of Kitale, a very arid desolate land of people who herded cattle.  Bosco rescued him from the streets of Kitale and sent him to school.  He graduated first in his class.  So Russ asked us if Ben could volunteer at the hospital and we found him to be a very kind and gentle young man.  Next Russ found a donor for school fees but they were only enough to be trained as a physician assistant.  Russ remembers me saying under my breath...I hope he goes back to Turkana.  Well, he did!
     Last month I received an email from Fr. Tim in Sudan asking me about a medical problem for a young girl from Toposa in Sudan who was studying in Turkana.  I needed someone to examine the girl and wondered how I could contact Ben.  A few days later, just by chance, I received a text message on my phone from Ben asking me about a medical problem.  I now had contact with Ben and between the phone and the email the girl has gone to the hospital where Ben works and we have been working to solve her problem.
     Never in my wildest dreams could I have envisaged practicing medicine using technology to assist a young health care worker in a very remote place.  I am so happy to see younger people caring for one another in this way.  The Toposa and Turkana are historically enemies who raid each others cattle.  But now they are helping one another to heal their illnesses and go to school.
     On Friday 24 May we will see another full moon.  Look up at the sky and enjoy the beauty of our world and thank God for the good people who are trying to make life better for others...each one of you included!

28 April 2013

     I have a calender of the Sisters of St. Joseph from LaGrange and today the saying is "grieve over loss".  That is appropriate for Judy and I as Mary, our house mate and co-missioner for the last three years has returned to the US on Friday.  She worked with the HOPE = Helping Orphans Pursue Education program and did a wonderful job under very difficult circumstances.  She will now go for her Master's degree and although we will miss her very much we know that it is the right decision and wish her well.
     A friend asked how we didn't get stuck on the muddy roads below and the answer is that we had a good driver and a good vehicle with four wheel drive that took us through the bush where the ground wasn't so muddy.  She also asked how we haven't gotten sick with Dengue fever when the people downstairs have.  We are very vigilant about killing mosquitoes and making sure that we don't get bitten by them.  It's a challenge but so far we've succeeded.
     I saw a two year old child at the Likoni clinic last week for follow up.  The little boy only weighs 16 pounds (8kg) which is the size of a one year old child.  His mother has taken him to the clinic every single month of his life and the health workers just kept writing down his weight and watching it fail to increase.  When I examined him last month I thought he might have muscular dystrophy and referred him to the provincial hospital.  They could do only the most basic tests and told the mother to bring him back to see the specialist.  When she returned the specialist wasn't in the clinic.  They told her to return in another week and when she did they told her that the specialist didn't have time to see the child and to return next week.  Such are the struggles of people  who can't afford private health care.  I will follow up on the child and use my mission money to get the tests that he needs if the government doesn't do them.  His prognosis is not good but at the very least the mother deserves a diagnosis and support to help her care for her child.

20 April 2013

Road to Taveta

Trucks stuck on the road to Taveta

I finally got my pictures of the trip back from Taveta to show the kind of roads were had to deal with.  The rains continue and the farmers are happy but there is flooding in many parts of the country and as you can see it makes travel difficult when there is no road.  This Class A International Road connects Kenya to Tanzania and travels through Tsavo West National Park.
     The week long trip was very needed and we found lots of problems to deal with.  The renovation of the maternity unit in Eldoro is still not complete and we could not return to Eldoro on Thursday as planned because the road was impassable.  It didn't matter as the contractor who had told Sr. Pauline he would meet with us on Thursday was no where to be found.  We talked to the foreman and told him the work must be done in one month or we will hire another contractor to get the unit open and functioning by 1st July.
     This past week in Mombasa we were told by the government that there are at least 57 cases of confirmed Dengue fever along the coast.  Three people in the family downstairs and a Sister on South Coast have all been very sick.  It is a virus spread by mosquitoes that are breeding with all this rain.  I haven't seen any public health announcements in the papers or on the radio.  It probably would not be good for their tourist industry for this to be publicized.  So on Friday I traveled to Mrima and began our teaching for the staffs in outlying areas.  Fortunately the road was paved and we came and went in the same day!!!

10 April 2013

     Yesterday 9th April 2013, the government of Kenya spent Kshs300 million ($3.6 million) on the inauguration of the new president and vice-president.  It was a public holiday but Sr. Pauline and I chose to work as we had already planned a week long trip to the villages.  Let me give you a perspective from where the common people live.

     On Sunday we began our trip and met a huge traffic jam at a weigh station outside of Mombasa.  The machines for weighing the trucks broke down and I counted 440 trucks backed up for miles.  It took 4 hours, more than double the time it usually takes to reach our first clinic. The clinic went well but on Monday night the electricity went out all night long.  On Tuesday morning we left Voi early in the morning to travel to Taveta on the Tanzanian border.  This is a class A international road and half way there we met two trucks stuck in the mud.  The road used to be paved but now all the pavement is gone and it had rained causing great piles of mud.  I felt like I was having deja vu of traveling in South Sudan many years ago.  Fortunately our vehicle could slip slide its way around the trucks.  When we reached Taveta we found the road to the village of Eldoro was full of water so we took a different side road.  There were patches of mud but with four wheel drive we could get through.  We reached Eldoro and spent 3 hours at the dispensary.  On leaving at 6pm we tried to take the normal route but found a truck stuck in the mud.  So we backed up and returned on the small muddy path we had come through earlier.  We reached our next village destination of Chumvini at 7:30pm last night.  As we traveled at night I noticed that there was electric lighting in the distance where Tanzania is.  There was no electricity on the Kenya side we were driving through.  Sr. Pauline explained that rural electrification still hasn't reached this part of Kenya.  I did a clinic here in Chumvini today but the lab technician had trouble reaching the clinic because the road was muddy.  Another vehicle tried to go to Eldoro today and failed because a truck was stuck in the road.  We have planned to return to Eldoro tomorrow to follow up on the building of the maternity unit but our success will depend on the rains and the trucks!!!

     All of this is to witness to the fact that while the leaders of the country can afford to spend plenty of money on the inauguration the common person still lives in the dark and has trouble moving themselves and their goods from one place to another.  I hope that we can give them good quality health care services to make their lives less difficult.  So far, I'm really glad we've avoided getting stuck in the mud!!!  I wanted to take some pictures but the camera on my phone had run out of charge due to lack of electricity.

1st April 2013

     It is a cool rainy morning here in Mombasa and we had a lovely Easter celebration with 11 friends in our home yesterday.  All is calm and we are grateful for the peaceful acceptance of the court ruling Saturday evening.  The court made the unanimous decision that the elections were free and fair and that the two men elected president and vice president will be inaugurated on 9th April.  This is the end of discussion and there will not be anymore appeals or legal challenges in Kenya.
     Judy works in Bangladesh slum and I will go there for a clinic tomorrow.  In 2008 this slum was the center of post election violence and many people were hurt and killed.  This month the priests (St. Patrick Fathers from Kiltegan in Ireland) report that some police came and beat up youth with sticks while they were playing on the football field and prevented other gatherings of people.  But the people didn't fight back and there was no escalation of violence.  The parish has been working diligently to help people channel their anger nonviolently and they have succeeded.  In addition, all three priests are older than me and live in the slum with their parishoners.  I suspect that Pope Francis would be approving of their lives of service!
     Most people I have talked to just want to put the election process behind them and get on with their lives.  They want to make a decent living and send their kids to school.  For me, the concern is for those people who suffered during the violence in 2008.  I heard many of their stories and know how much they suffered at the hands of people well known to them.  I hope that they will be able to tell their stories at the International Criminal Court in the Hague.  But recently the court had to drop charges against one man because the witnesses had died, been killed or changed their minds and refused to testify.  The Hague also said that the government of Kenya was not cooperating in providing what was necessary to determine the truth.  Now, two of the three men still charged have become the government of Kenya!  I doubt they will do a better job of 'cooperating'.  I feel very  sad for the future of these people and the country as a whole.  This is not a very joyful Easter for me.
     But I will go to work tomorrow and do my best to serve the needs of the people who come to the clinic.  I'll take heart in knowing that there are many of you who are keeping us in thought and prayer and admit that I can only do my little part.  Wishing you all a very Happy Eastertide and the arrival of Spring as soon as possible in Illinois!