Kenya Update 4 - Miwani area

 Kenya – Miwani/Nehemiah International

At the clinic this morning I spent some time with our staff and future potential staff; getting to know them and their background and experience.

Today we had a case of an elderly fellow (maybe 45-55) who has had intermittent fever, photophobia, headache, weakness. No diarrhea. Esther, our nurse, felt this was c/w either malaria or typhoid. Ken, our lab tech, was able to test for both, and it was typhoid. He received 1.0 gm iv Ceftriaxone. No iv fluids, just slow push of the drug. He is to return daily for 6 more days for additional iv doses.

Cisco is in her early 20’s. Here now briefly on school break. She is in school as a CO – or Clinical Officer. Just finished her first year. She will have 3 years of school, then 1 year of internship, which is sort of the payback time to the government. She can rank her top 3 choices, then will be placed at one of those. The school is state/Kenyan supported and costs 60,000 shillings per year (40,000 tuition + 20,000 living expenses [hostel and food]). She absolutely wants to work here when done with training. They do get basic sciences. Gross anatomy is using cadavers, but with someone dissecting for them. They can touch the cadaver if they wish, but do not have to. Otherwise sounds like PA school a bit; but not as thorough. I asked her about the brachial plexus, and she said that week the professor was not available, so it was discussed but not in that much detail.

The circumcision clinic seems, so far, to not be happening.  Last week a team had arrived to circumcise 6 males, and they were to have follow-up today.  For the procedure I understand they get Tylenol for pain relief!

We, Anneliese and I, headed for Kayo which is a small village near the town of Miwani. We were to visit Momma Mylka who is the grandmother to Jeff Krueger and Anna Schuler. After nearly 1.5 hours of rough road, single lane much of it, we are surrounded by trees and huts – some with thatched roofs, some with tin. Smooth hard dark dirt floors (which I later learned are cow dung and dirt), almost like concrete, mud walls supported with sticks inside. One or two windows per hut.....

The latrine is a 3 sided open structure, almost no privacy, used it appears just for stool; not likely urine.  Shallow hole covered in part by sticks and mud. Located maybe 40-50 feet from the nearest hut. Water for cooking/bathing/possibly drinking from a barely moving stream, which is “boiled” we are told. A nearby well provides most of the drinking water. Small gardens, a few goats or a small cow or two, small dogs and usually no cats.

Kids happy, swarm around me to shake my hand and want their photo taken. Most very happy and yell out “Mizunguu!!” or “How are you?”, especially the latter over and over! They especially wanted to see the photos I had just taken of them. Anna Schuler, almost 4 yo, was here, she ran to greet me and held my hand for the 200 meter walk into the village. One dog was snarling, and not too friendly, we stayed away given the recent rabies in the area.

On the way back we saw a currently closed dispensary in Miwani and the Make Me Smile project of orphan girls in a re-purposed pickle ball court. They have a pond for fish and small garden patches. The house mom appears maybe 20 yo. This house rented and supported by a few young Austrians whose father apparently gave them each some funds and told them to find a 3rd world project to make a difference in peoples lives.  Around 8 girls living in this pickle ball court, ages roughly 8-20. Might have electricity, but we did no see any evidence of that.  Most homes, like this one, use a charcoal interior fire for cooking.  Usually a small, roughly 16 inches by 16 inches base that holds the burning coals just off the floor, with a pot on that for cooking Ugali or other items.  Yes, this does put out CO, or carbon monoxide.  Apparently the ventilation is good enough, as this is the standard everywhere - even in homes on the farm at NI.

Dinner back at the farm – Ugali and greens. 

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