Yes, the title is correct! In less than 2 weeks I am headed back to the Kisumu area for more medical work. This trip will be for a bit more than 4 weeks in length, returning home in time for our 30th wedding anniversary! I will be leading a team of 4 college aged adults from Bainbridge Island, who will help me along the way.
I will be involved in several medical adventures this time; whereas the first trip involved more observation and understanding of the Kenyan care delivery system, this trip will include many more hands-on endeavors from teaching at a medical school near the Siaya District Hospital for nearly a week, to studying the health of two separate populations. One of these near Siaya, the other close to the Nehemiah International property/farm east of Kisumu.
Dr. Jackton Omoto, chief of staff at Siaya District Hospital, has asked me to speak to medical students and medical officers on various topics of Emergency Medicine. We are still working through those details, as he initially hoped I would be able to provide 6 hours of lecture per day for 5 consecutive days! I simply do not have the time to prepare that much material. Instead I have suggested I would be able to teach over 2-3 days; including several problem based learning cases (an interactive teaching method I have learned as a volunteer at the University of Washington school of medicine the past 6 years). Additionally I would like to spend a day or two observing emergency care delivery in the Siaya hospital to see if any improvements may be realized - looking at everything from supplies, response to crises, available medications and testing capabilities.
While in that area, Dr. Omoto has asked that our team survey the health of children and adults. I have been purchasing equipment to perform a basic health assessment on people for this trip. This will include BMI (body mass index - which gives a very good sense of nutritional status from age 2 to adult via measuring weight/height/age), hypertension screening in all over age 20, visual acuity, and dental hygiene - looking for obvious cavities. For villages we hope to obtain population, births and deaths in the past 12 months, mosquito net use, sanitation (garbage and human waste) and water sources.
This will also be undertaken in an area around Nehemiah in an effort to begin to understand the health needs of the community and how we can begin to meet them. More details below.....
Our Nehemiah International US team has been meeting every week to determine how to best put a survey together. This effort will be supported in a huge manner by 18 Bainbridge High School students who are traveling to Nehemiah in mid-July, just after I return. These students and 3 teachers from Bainbridge will spend up to 6 days further collecting data and the information described above in villages and schools around Nehemiah.
The entire area that the Kenyan Ministry of Health wishes us to cover, or provide services to, is 40 square miles in size. Though we do not know how many people live in this area, our best guess at this time is 15,000. We do know from the Global Millennium Project study that the HIV/AIDS incidence is 15% in this region; that infant mortality is 12% by age one, and 22% by age five. This is most likely due to malaria and unsafe water/diarrheal illnesses. By getting a sense of the BMI, and some basic screening parameters we hope to impact the mortality and improve health. Though there is no way to cover this area completely, the more people we can study the better. The last available data for this area was from a WHO study of BMI in 2003/4 when roughly 1500 women around the Kisumu area were evaluated.
Beyond the above objectives I would like to look at how we are currently using medications at Nehemiah for various illnesses. Whenever possible using the least expensive effective medication; likely pills. Though effective, IV meds are expensive; and we are likely to be able to treat many many more people with illness by using oral meds (before we exhaust funding, which depends upon generous donors).
That is all for now. I have been very busy - but wanted to quickly get an update posted. I will do my best to keep blogging going while in Kenya. IF you are looking for a tax deductible donation (Nehemiah is a registered non-profit in the US, and a registered NGO as well) - to help provide medical services to this area of western Kenya, or even to help offset some of my out of pocket expenses for supplies and travel, those donations can be sent to Nehemiah International, PO Box 11791, Bainbridge Island, WA 98110 with a note stating your donation is for medical care.
Next, I plan to share my thoughts on how we can use community health workers to directly impact the health of villages, and how they can alert us at the clinic to a sudden illness that may require transport to either the clinic or local hospital in Kisumu. Thanks for reading!