Jambo, Rafiki

Kiswahili for Hello, Friends! My time here is paying off.

This morning we had the most amazing juice made from Passion fruit. Delicious. We drank this and ate homemade bread on the way to the airport. We were afraid we were going to miss the flight as we only got there 20 minutes before take off, but our worries were eased when we arrived and realized the four of us made up 1/3 of the passengers and they would hold the plane if needed. We made it just fine.

Our flight to Eldoret went smoothly. It was a pretty unique experience. Our plane was a little twin engine jet that sat about 15 people plus the pilot. I was behind the pilot and one of the propellers was to my left so it was quite loud. The surprising thing was that our flight attendant, who passed out snacks before we took off, was also the co-pilot. Or so we thought until we took off and she turned out to be a STUDENT pilot! She did well though. Just a bit wobbly on the landing but I suppose I would be too trying to land in the middle of a field! We flew low and got a good view of the terrain. I was actually able to watch over the pilot’s shoulder to see out ahead which isn’t a view you get often. I didn’t realize how mountainous Kenya is. We flew to the west and I’m pretty sure we were able to see Mount Kilimanjaro in Tanzania to the south in the far distance.

The airport was a dream. All open air to the 70 degree weather, maybe 20 other people besides us, and all in the middle of the field surrounded by the most beautiful view you’ve ever seen. Our preceptor, Sonak, picked us up from the airport. Here, they drive on the left side of the road and the steering wheel is also on the left. I suppose this is from the strong British influence. Sonak drove us through town and gave us a tour. There aren’t really rules to travel other than “don’t get hit.” So this meant we were weaving in and out of traffic –both sides—and pedestrians at a high rate of speed. Kenya is much greener and cleaner than I expected. I suppose I was expecting to have similar surroundings to Port-au-Prince, Haiti, but there are lots of trees, no humidity, and people pick up after themselves for the most part.

Upon arrival to the IU house we were assigned our rooms (Ashley and I in the Candelabra room and Alan and Avery in the Sausage Tree room). Our rooms are right across the hall from each other and we share a bathroom. It’s nice to have everyone close. We then took a tour of the hospitals in which we will work. I suppose at this time I should take the time to explain for everyone what I’m doing here.

I’m on a two-month Adult Medicine rotation for my last year of pharmacy school. I will be working at Moi Teaching and Referral Hospital (MTRH) as well as AMPATH, a hospital set up specifically for HIV/AIDS patients. Moi University is a medical school named after a past president. Apparently, the tradition here is when someone is elected president in Kenya, he makes significant donations and improvements to his hometown and tribe. This is why there is such a vested interest in the elections, thus helping to explain the post-election violence last winter. (Speaking of, a lot of the violence happened right here in Eldoret and there are still about 1,000 displaced people living in tents on the edge of town). MTRH and AMPATH hospitals are directly next to each other and connected by an outdoor corridor. The center is huge and they are still expanding through donations and grants with a beautiful 3 story mother-and-baby hospital newly built. They are only waiting to open it by hiring staff. MTRH has four wards: males, females, male children, and female children. Each ward has 6 “cubes” and each cube has 8 beds and each bed has 2 patients…this equals a lot of patients. Each of us four will be assigned to a ward. We will find which ward we are assigned to on Monday. The smell of the hospital is unbelievable. You about hit the deck just walking in. Combine body odor, human waste, and just the normal hospital smell from a couple hundred people and multiply that by 1000 and that can give you an idea of what it smells like. The UNC medical resident we are with actually threw up about 5 separate times and had to eventually leave. The tuberculosis prevention mechanism (as you know, TB is contagious and spreads via cough droplets and subsequent inhalation) is open windows at the end of each cube. Not very reliable. This does provide a nice breeze which is nice as it is quite crowded and hot in the hospital. MTRH care is all on the patient to pay. For example, though x-rays cost about 25 cents US, patients can’t afford the cost and usually go without. This also applies to surgeries, medications, and other basic, essential care which is quite discouraging.

AMPATH on the other hand is a free service to HIV/AIDS patients. Currently about 75,000 patients are treated with appointments on a regular basis and free ARVs (antiretrovirals). We are responsible for assuring patient compliance and reviewing patients charts to identify drug interactions and initiate medications where necessary. AMPATH smells better but is just about as crowded a place as Moi.

We were all overwhelmed with our responsibilities we learned on the tour so Sonak gave us the afternoon off to unpack and get settled in to our new Kenyan life. With the 8 hour time difference and travel we were getting pretty sleepy so we took power naps and checked out the IU house compound. For dinner, everyone at the IU house –about 30 of us, went out to eat at an Indian restaurant in town. The med students and residents here were going out to explore Eldoret night life, but we elected to head home and sleep to try and adjust to the time. Everyone keeps telling us to give it a few days and we’ll be pros both at the Kenyan life and our duties at the hospital…I trust they’re right because at this point, the 4 of us are in over our heads. We have to prepare ourselves to work and to work hard. Everything we do is not for our job or because our preceptor asked us to do it. Our work here is to ensure patients survive. And that is motivation in itself.