Last day at Fluorspar

Our last full day with the Fluorspar team.  And it was a busy one!

It began as usual with rounds at the clinic.  And while we were asleep another mother delivered a baby!  Dr. Michael did the neonatal examination and all went very well.  Mother and baby are perfect!  One observation we’ve made was that the mothers do not have access to diapers.  The baby is swaddled in (I’m not kidding you) 3 or 4 blankets plus the clothing!  Basically the baby soils the clothing and blanket and then the mother must wash all of it!!  We have an idea that we will create a “new baby” kit to give to the mothers before they leave the clinic.  This will include among other things, diaper cloths.  We’re going to buy large rolls of cotton sheets that we’ll cut into squares which they can use as diapers.  Certainly not perfect but at least they will only need to wash the cloth and not blankets and clothing!

We had a patient who came in with chronic anemia and concern of bleeding into his colon and is suspected of having colon cancer.  The clinic staff was educated by Dr. Ed and Dr. Michael on the difference between acute and chronic anemia and bleeding into the gastrointestinal system in an elderly person.

Dr. Sidiqa and Jemima had a chance to distribute more prescription glasses.  And most importantly Dr. Sidiqa had an opportunity to assess Jemima’s ability to accurately determine a patient’s prescription, which in her words was “bang on”!  This is exactly our goal.  That when we leave, Jemima will continue to help her community without our help.  We’ve told her as well that when she decides to leave the clinic to pursue her studies (she’s expressed an interest in becoming an optometrist!), she has the responsibility to train the next person.  To share the knowledge that she now has so that her community will continue to have access to prescription and reading glasses and basic vision care.

We then departed for the outreach and I must admit were a bit anxious to whether the Chief would keep his word and produce patients!  We were especially worried as it is Sunday and not uncommon to go to Church here from 8AM to 7PM.  Thankfully we arrived to many people waiting to be seen.  The outreach is done at the local school in two separate classrooms.  This school is in good condition with clay flooring, lots of windows, brightly lit and good air flow.  The worst part is the tin roof which radiates heat downwards.  But again, this is a nice school and the community very friendly.

Dr. Andy was busy with MSK patients presenting with many different aches, pains, joint issues, etc.  He continued to train Samuel on the types of exercises and strategies to prevent and reduce chronic pain.  Samuel has taken a great interest in MSK and is thinking of becoming a chiropractor or physiotherapist.  Dr. Andy has been kind enough to forward on to him loads of journals and reading material digitally.  It is amazing to think of the potential longterm impact this will have not only on Samuel’s life but the lives of his community if he were to bring this expertise back to Fluorspar.

Dr. Miners and Samuel with a patient

Dr. Miners and Samuel with a patient

Dr. Michael had an interesting case where he saw a child whose mother complained that her daughter was eating charcoal.  This compulsion, called pica, is in fact a sign of iron deficiency which is common here.  The young girl will come to the clinic tomorrow for a blood test to confirm the diagnosis and will likely be given iron supplements.

Dr. Sidiqa continued to educate Jemima and the community on proper hygiene for the eyes.  The #1 complaint is eye “allergies”.  But in fact it’s not allergies but rather poor eye hygiene and dehydration.  She encourages washing of hands and drinking as much water as possible.  Access to water very much depends on where you live in the region.  This particular area is quite dry.  Water sources can be miles away and even then needs to be purified before drinking.  It is not an easy situation to say the least.  

But the vision team is having a good time today as the locals are having fun doing vision screening on themselves.  Jemima continued to distribute reading glasses and anyone who appears to require prescription glasses is asked to go to Fluorspar clinic for a more thorough exam with the auto refractor.

A boy with a new pair of glasses

A boy with a new pair of glasses

Tomorrow we’ll spend the morning at Fluorspar Clinic before departing for Eldoret.  We’ll be meeting AMPATH, a consortium of universities including Indiana, Duke, University of Toronto and Moi University, a medical teaching hospital located in Eldoret.   AMPATH has been very successful in training Western Kenya medical staff on diagnosis and treatment of HIV and cervical cancer.  We’re hoping to listen and learn from them, especially as it pertains to cervical cancer.  We’re planning to launch our womens and children health campaign in November and would like to offer HPV vaccinations to girls aged 9 to 13.  Cervical cancer is a killer of women worldwide and is preventable from the vaccination.

We also plan to begin virtual case review from Kenya to Medcan’s clinic in Toronto.  Every other Friday and on an as needed basis the clinical officers will discuss their most complicated cases with Medcan doctors in Toronto via Skype.  We’ve tested the connection (visual and audio) this week and it worked very well.  We’ll begin the first session on Friday April 17th.  Tomorrow we’ll do one last training session with Julius, the head clinical officer at the clinic.  Telemedicine is an essential part of our sustainable strategy, enabling the staff to continue their learnings virtually.  Our goal is to have them use Medcan doctors on a consultative basis empowering them to offer their community a higher level of care and in turn achieving better health outcomes.

- Stacy Francis