Day 11: Heartbreak & Celebration ... Our Last Full Day

 Dr. Michael having an early run with the house dog Lucy. 

Dr. Michael having an early run with the house dog Lucy. 

Our fifth day at Fluorspar and our last full day. We’re headed to the only outreach we’ll do on this particular trip.  We will be going to a new location for us and for the Fluorspar clinic staff. It’s up high in the mountains about a 30-minute drive from the clinic. We arrive to a group of young children and their teacher.   

 The welcoming committee

The welcoming committee

 The location of the outreach is in a church. 

The location of the outreach is in a church. 

The outreach will be held inside of the community church that also serves as the nursery school. The teacher gave us a tour of the outside area around the church.  First we see 2 pots boiling over a wood fire.

 The teacher of the nursery school explains the cooking pots. One for rice and the other for beans. 

The teacher of the nursery school explains the cooking pots. One for rice and the other for beans. 

One pot was full of water that will be used to cook rice.  The other was full of boiling water and red beans.  Combining the beans and rice is a typical dish here.

 Pot full of beans. 

Pot full of beans. 

I’m wondering why there is no maize in the pot in order to make their traditional dish, githeri.  I think I may have my answer when I am shown the storage area for keeping the maize and I see that it is empty. 

 Storage space for maize. The structure is made of mud. 

Storage space for maize. The structure is made of mud. 

It comes to my mind the lack of rains in August and that the price of food increases in the dry season, even more so when the rainy season never came.  For this population the meal will now consist only of beans and rice with no maize or greens.  Although they may not go hungry they are lacking the important nutrients that improve their immune systems and overall health.

Inside the church

The Fluorspar staff begin to setup for Dr. Michael and Rahema who will see children and adults and Dr. Sue who will conduct cervical cancer screening clinic alongside Samuel.  We will divide and conquer today with Dr. Sidiqa and Alex visiting the Fluorspar school doing vision screening and nutritional assessments and education.

Faith, the community health worker who we met earlier in the week, is here doing chronic disease screening.  All of the adults are given a sheet of paper with their blood pressure, age, whether they are diabetic, a smoker or drink alcohol.  We are thrilled to have her here screening patients and collecting data which continues to be compiled back on the computer at the clinic.

During this process, we were presented with a man complaining about a ulcer on the bottom of his foot.  Despite the fact he’s able to walk he is not able to feel his legs from the knee and below.  He is presenting as an end-stage diabetic who will likely need to have his foot amputated at some point.  He’s been instructed to go to the Fluorspar clinic to have a proper diagnosis and receive medication.  He will be educated on managing his diabetes both with medication and nutritional strategies.

We give him antibiotic to treat the foot and advise him that his infected foot is likely due to diabetes and that it’s essential that he comes to the clinic for treatment.  He promises to come and we pray he does to minimize any further preventable damage.

A son arrives carrying his father

One of the most heart-wrenching moments was when a son arrived carrying his father. The father suffered the effects of leprosy from years ago.  His foot had been amputated and was replaced with a wood peg.  And his toes on his other foot were also removed.  Although the leprosy had stabilized, he was now suspected of having tuberculosis.  He will need to come to the clinic to have a confirming diagnosis and begin his treatment.  His son assures us that he will get him there. 

The sight of him scooping up his father (who was arguably larger than the son), thanking us with such gratitude and then leaving with his father in his arms will simply never leave me.

 Some of Dr. Michael's patients. 

Some of Dr. Michael's patients. 

Dr. Michael also saw 2 young girls, who are pictured above. The one on the left is 9 years (in yellow) and the one on the right is 5 years old (standing).  After taking a history and conducting a clinical examination Dr. Michael is suspecting syphillus.  Her father will bring her into the clinic to be tested and begin treatment.  Although it will not fix the damage that has been already done she will now begin to develop at a more normal rate.

Outside of the clinic in the church, you never know what you will find around the corner ... like the obstacles I encountered on the way to the outhouse. 

 On my way to the outhouse, the white building. Needed to literally excuse myself around the chicken and the cow as they had no intention of moving. 

On my way to the outhouse, the white building. Needed to literally excuse myself around the chicken and the cow as they had no intention of moving. 

Dermatologists in high demand in rural community

We also notice several skin conditions today.  Our plan is to bring a dermatologist with us on the next trip.  The clinic claims that skin diseases are the second most common ailment, just behind upper respiratory tract infections.  We see a myriad of conditions today and I am making a list and taking photos so that I can share with our dermatologists.  Eastern Africa has many skin conditions specific to its region and we want to make sure the dermatologist will be familiar with the unique issues.  

Cases included one that had begun to scab and showed signs of squamous cell carcinoma; one child had symptoms of ringworm; and a young girl had an advanced-stage fungal infection on her head.  The conditions are not easy to look at and are not what we are used to seeing back home.  But these are the very real issues that many rural communities in Africa deal with every day.  It is our goal to provide education to the staff so that they are better prepared to care for their community.

Nutrition Q & A with Dietitian Alex

Alex had an opportunity to speak to the children at Fluorspar primary school.  She gave them a nutritional talk and answered all of their questions.  She also had a chance to speak with the chef who prepares the food for the students many of whom are boarders.

The menu includes very typical dishes of the area including githeri, ugali and a treat on Sunday mornings, mandazi.  We notice that vegetables are listed every day which is not common in the public school system.  Fluorspar does a far better job than most of the schools with a more balanced and healthy diet.  Still, Alex will be making some recommendations to make it even better.  Likely her first suggestion will be to cut down on sugar.  The traditional tea that is served has a lot of sugar in it.  It’s absolutely delicious!  Having tea is one of my favourite parts of being in Kenya.  But my team reminds me that having 2 or 3 cups of it likely puts me over my daily allowance of sugar.  There is that much sugar in it!  So the recommendation will be to reduce the sugar and to reset the taste buds.  Apparently it takes 3 weeks to readjust our palettes so that we are satisfied with less sugar or salt, etc.   So this will be first on our list.  Perhaps it will be easier to suggest taking something away vs adding to the overall cost of the food program. 

Vision Screening at Schools

Dr. Sidiqa began vision screening at the schools.  She was working with Jemimah and Noah on how to do the screening properly so that they will continue when she is gone.  The goal will be to screen all of the children by the time we return by February and then move on to other schools in the community.  Any children requiring glasses will come to the clinic to be examined by the auto-refractor and prescribed and provided glasses.

Staff Party

We all headed back to the guest house to prepare for dinner as we were having the clinic staff over for a little party.  We had so much fun speaking with them on a more personal level, learning about their families, their culture, and, of course, their music!  I’ve already downloaded three albums which are amazing.  It’s a little part of Kenya that I can carry with me wherever I go and think back to this amazing group of people who care so much for their community.

Tomorrow is our last day.  Hard to believe it has finally come! Check back tomorrow for the last post!

- Stacy