Clinic

Kenya Relief holds three days of clinic every week there is a team in Migori. Clinic days start early and run late. Many patients come from all over Kenya - I met a lady who traveled eight hours to see the doctors from America. For some, we are their only hope for treatment.

For myself and the majority of my teammates, it was our first time to serve with Kenya Relief. We all had to think outside the box and step out of our comfort zones. Although most of us had just met and had never worked together, we shared a common goal: to help as many people as possible in our short time here. I felt our team worked really well together from the word 'go'. In three days, we treated over 500 patients and performed 25 surgeries. An excellent group of ENT surgeons from Harvard university did a superb job removing many enlarged thyroid glands (goiters) in a setting that was completely unfamiliar to us all.

Every anesthetist knows patients with large goiters can be some of the most challenging airways to manage. As you can see in the pictures, these patients had MASSIVE goiters. Although their were two patients that we were unable to intubate, every patient was safely managed. I was proud to be apart of such an outstanding group.

In America, we have so much equipment and supplies at our disposal. I was impressed by what equipment we did have in Migori (thanks to generous donations). We had fully functioning anesthesia machines (with scavenging running out the window), suction, bovie cautery, and even an air conditioning window unit. Back home, we use a monitor called a capnogram that measures the amount of each gas being exhaled by the patient. We did not have a capnogram at the clinic so we had to use other data to ascertain the depth of the anesthetic being delivered. This was an intimidating challenge at first but I feel everyone adjusted quickly and became fairly comfortable without the monitor.

Power at the clinic comes from a large generator that was graciously donated. I now know it is not a question of IF the power will go out, it is WHEN. The first day of clinic, we had multiple power outages which presents many issues in the operating room in the middle of surgery. Without power, you are unable to deliver anesthetic gases or look at the patients vital signs on the monitor. Most of the time, the power was only out for a few minutes at a time, but we did have one instance in which the power was out for at least 25 minutes. I was impressed because everyone in the OR kept their cool. We held flashlights over the field and the surgeons continued to do what they could without power. Molly and I had brought our precordial stethoscopes which allowed us to monitor the patient by listening to their heart tones and breath sounds. We placed a portable blood pressure cuff on the patients' legs and gave bumps of propofol to keep the patient asleep. It was an experience to say the least. =)

This week, I have experienced a roller coaster of emotions - joy, overwhelming sadness, love, anger, hope, helplessness, shock. One patient in particular had a huge impact on me. Her name was Velma. Although her mother claimed she was six months old, she looked no older than a month or two. She was extremely malnourished and what we in the States would consider 'failure to thrive'. The more we learned of this baby's story, the sadder it got. Her mother was twenty years old, HIV positive, and had already had one baby die. It appeared as if she herself had been eating well... She claimed to have been trying to feed Velma porridge. This situation angered me. Velma will eventually die. Even if she happens to not have HIV herself, she has not had adequate nutrition to develop properly. I am angered so because this situation will repeat - it happened to Velma's sibling and will continue to occur. Depending on how the mother's disease progresses, she may have many more children in her lifetime. This is just one story out of one million. I am certain there are thousands just like Velma. I think of my sweet, healthy, chubby nephew, of how fortunate we all are and we had nothing to do with it. You do not pick where you will be born. Every child deserves a chance at life. It is so unfair that some on this planet have so much while so many go without.

I am thankful that we were able to help so many people in the community this week. I am humbled by the spirit of the people of Kenya. If only we could learn from them, we could have much fuller lives and live contently instead of always wanting more. One of my friends favorite quotes keeps resonating with me - "I am a part of all I have met" - Velma will always be apart of me as will many others here. I believe this experience changes you, changes your heart, changes your thinking, hopefully changes your actions. I plan to continue to do what I can to make conditions here better. I hope to open your eyes to life here so you will do the same.

Now, we head to the Masai Mara for two days of safari. It is dawn and we should be in the park in a couple of hours. Still can't believe I am here. Someone pinch me.