Healthcare in a Kenyan slum

I’m quickly running out of days, yet have been unable to write about all the things I’ve seen, and people I’ve worked with. I leave for Nairobi tomorrow morning, spend the day there, and then fly home early Friday, landing at Heathrow the same day. I’m completely gutted to be leaving. I’ll miss my friends, who are all so inspiring in their commitment to their different causes helping Kenyan healthcare.

Multi-National Healthcare

We held a BBQ on the roof of the one of the apartments last night, and there was such a mix of people up there – Aussies, Brits, a Canadian, a Kiwi, a Czech, a German, an American and a healthy dose of Kenyans. It’s quite a team and I’m very sad to have to leave so soon after finding my feet out here…. I’ll miss Africa and Kenyans. There are many things about this country that need help and work, but it’s so full of good, loving people and it has so much potential – it’s a shame that no sooner do I find myself ‘Africanised’ that I’m heading home…

Mostly though, I’ll miss the sense of purpose I have out here. Although I’ve not belonged to any single organisation, I’ve done my best to bring as much energy and enthusiasm to each place or project I’ve worked at. Some of these volunteers are out here for a long time, miss their homes and find certain aspects of Kenyan life quite frustrating. People like me can hopefully help keep them motivated, and fit in where necessary. But all the more reason to come out again, as soon as possible. And I’ll be looking for other like minded souls to join me, so have a think about sparing the time 🙂

Nathan Hall Williams Center

Today I’m going to write about a day I spent on a free medical clinic which was put on by the Nathan Hall Williams Center. The NHWC is a healthcare organisation run by an American called Haley Williams who lives close by, and has been out here four years – Longer than any of the volunteers I’ve met out here. The NHWC run a variety of healthcare-based projects, one of which is a weekly medical clinic for Nakurans. I agreed to help out last Friday in a region of Nakuru called Rhonda – one of the very poorest areas of the city, described by one of the Rhondans that day as “a real ghetto.” I’d had a brief visit to Rhonda the week before with ‘Raise The Roof’ but this time I spent the whole day there, and met an awful lot of people first hand.

Rhonda

I went into Rhonda that morning on a mini-bus with a team of 10 medical staff; doctors, nurses and administrators. We stopped at one of the local hospitals to pick up the drugs and supplies, before heading into Rhonda. The night before had seen a torrential rain storm, the effects of which were only too apparent as we got into the district. There is little or no drainage in Rhonda, and it is also situated in a bit of a bowl at the bottom of the city. Therefore an awful lot of rain water which falls, runs straight down the hills, and sweeps through Rhonda; often with catastrophic results.

Haley told me that the night before, about 20 houses were just washed away, and the roads (which are nothing more than rocky dirt tracks in places anyway) had become wet, muddy and extremely difficult to pass, with large pools of water sitting everywhere. It was slow going and when we got to the base (the healthcare clinic was being held in a primary school which was closed for school holidays) there was already a fairly large crowd of people gathered, waiting to be seen. The children were immediately fascinated by the unexpected ‘mzungu’ visitor and as soon as I stepped off the bus, I was surrounded by a gallery of smiley faces, and had a lot of tiny hands to shake!

Healthcare at The Clinic

We unpacked the bus and took everything into one of the buildings (pictures are on my Facebook profile). The room was large, long and dusty, and reminded me of an army barracks. The first thing that struck me was how unsuitable this was for a medical clinic, for reasons of hygiene and steralisation. But the fact is NHWC have no alternative venue for Rhonda. No one has a car in a slum area like that, and if you put it too far from where they live they simply won’t be able to attend. After lifting and helping to set the room up, I was put on the reception desk which was sat outside the front.

This is not like the UK National Health Service, where everyone has a permanent record, stored on a database. These people don’t even have an address, so upon arrival they register, and a receptionist fills out their details on a small, dated card, while someone else fills their details into a large record book. Once registered, they can then join the queue to see a doctor. However, before any of that could be done the cards needed to be prepared.

Oscar & Mike

I was joined by two young residents of Rhonda – Oscar (who introduced himself as ‘Oscar the Great!’) and Mike. They were both 21, had lived in the slum all their lives, and told me they were actors and comedians. They were certainly very funny guys, and the three of us had a lot of fun on our little medical card production line, making the admin ladies laugh. Oscar stamped on a logo, I stamped on some other info, and then Mike was hand writing the date, and passing it to one of the receptionists.

As we were working, they were asking me about England, London, the Olympics, and other places I’d travelled over the years. I was interested to know what they did, and what life was like in Rhonda. They told me later that they’d set up a Rhonda theatre group and were doing their best to develop it as a resource for local people. If you see Rhonda, you’d appreciate what a huge task this would be, as the people here have literally nothing, and certainly not money to pay for theatre tickets. Therefore everything Oscar and Mike do out there will be out of the goodness of their hearts and I had the utmost respect for the both of them.

To view the photos which accompany this blog, please visit https://www.facebook.com/media/set/?set=a.10151010762605849.416030.507640848&type=3&l=3f75e73334

Nakuru Rugby Team

Soon after we’d produced enough cards (approximately 400) we were joined by a few members of Nakuru rugby team. They were donating food supplies to the community and wanted to present the food during the clinic. With it currently being school holidays, there were apparently a lot more children floating around the premises than normal so the rugby team provided welcome distraction for a short while, bringing a few balls along and throwing them around with the children. And me, who couldn’t wait to get involved! As the only ‘mzungu’ present I was soon roped into the photo presentation, and also helped hand a load of sweets out to the children.

At this point, Mike and Oscar were going to take the food supplies (several large boxes of rice, maize and tubs of cooking oil) to the local community church, deeper into Rhonda, and they asked me if I’d like to join them. I looked at Judy, the girl who was ‘looking after’ me (so to speak) and she said “you’ll be fine.” So I jumped onto the open backed truck, and we were off! As I mentioned earlier, I’d been to Rhonda before, but I was in a car with one other mzungu, and didn’t really feel comfortable taking too many photos. To tell you the truth, I’d only been in Kenya a matter of days, and I was actually cautious just getting out of the car!

Food Supplies

This time was different though – I’d been here a couple of weeks, I’d traveled to and around Mombasa on my own, and I was also on a vehicle with three other Kenyans. I felt very safe, so I decided to get my camera out and film the journey into Rhonda. It was a fascinating 15 minutes, and when I get back to the UK, I’ll upload the video to Youtube. Unfortunately my internet connection here is too slow to upload it! As always in Kenya, the children were an absolute joy to behold. I spent the whole time waving to them, saying hello and exchanging smiles. Some of them chased the van down the road just to get a closer to look, or shake my hand. I’ve said it before so many times, but it was so heart warming, yet so sad that these gorgeous children lived in such squalor.

The longer the journey went on, the deeper we got into the slum, and the denser the buildings and people became. Many of the adults also smiled or said habari, although others just stared at me. It’s fair to say there aren’t many white visitors to an area as poverty stricken as Rhonda – it really is desperate for them there, and you have to see it to believe it. Even the pictures I’ve taken do not do the intensity of the area – the heat, smell and sounds – justice. A couple of times I asked Oscar, who was sat on the back of the truck with me, if I was ok filming the area, but he insisted I was perfectly safe, and to be honest I felt it – despite the harshness of my surroundings.

Healthcare Work

After getting back to the healthcare clinic some time later, the rugby team had left, and there were now a LOT more people there, including scores of children. Here, Oscar and Mike came into their own, and really showed what a funny and talented double act they are. They got all the children into a big circle, and started singing, dancing and playing games to entertain them. It was all in Swahili, so I understood barely a word, but even I found them extremely amusing. Every time they started a new game, I, as resident mzungu, was pulled straight into the middle of the circle, to be made an example of – you know me – I love being the centre of attention, even if everyone is laughing at me! By this point there was a crowd of adults watching as well, and considering we were at a clinic in one of the poorest areas of Nakuru, it was a real testament to Oscar and Mike how jovial the atmosphere was! I got some cool pics of this as well.

The Dispensary

Eventually the number of children around me increased, and they were all trying to get a piece of my arm or hand to inspect or hold. It was at first therapeutic talking to them all, but I started to feel like a clothes peg for ill children, so I asked if I could be put to better use! I was taken inside and put on the dispensary, which is basically a desk at the end of the room, covered in medicines and boxes of tablets. After being seen by the docter/nurse/physio, the patient takes their card, which the doctor has filled in with a diagnosis and prescription. They then hand it in at the healthcare desk, where the team of three (two, plus me as an enthusiastic extra) put together the medicine.

The atmosphere inside this building was nothing like that I’d just experienced outside, and I shouldn’t have been surprised. With all the healthcare, sanitation and social problems that come with a slum like Rhonda, there are some pretty poorly people, whose only access to healthcare is such clinics. They can’t just ring up their doctor and make an appointment like we do in the UK (I won’t make any NHS healthcare waiting room jokes at this point, as it doesn’t seem appropriate now) and illnesses which are easily treatable in the western world, can be killers in Kenya. And that’s before you consider how prevalent rape and sexually transmitted infections are in Rhonda.

NHWC Healthcare

At any NHWC clinic, it is mandatory for all patients to undertake an AIDS test before being treated. They also receive healthcare counselling at each stage of the process, because unfortunately positive results are only too common. (As it happened, there was only one positive result at this clinic, because I was told that this was practically a miracle, as there is normally a return of 5-8% positive tests). Bearing all of this in mind, it’s no wonder that there was quite a tense and sombre atmosphere at this area of the room. It was essentially the last stage of the healthcare process, and many of the people had been waiting for several hours to get this far. The children were restless, and their parents frustrated. I don’t suppose the previous night’s rain helped an already difficult existence, either.

Obviously not being medically trained, I couldn’t do a great deal on my own. However, I was put to use by counting tablets (the pills are handed out in brown paper envelopes) and pouring cough medicine and paracetamol suspension (Calpol, for anyone who can remember it) into small bottles from larger containers. I had no right to be, but was soon a little stressed out with the noise of crying babies and bored children. I was dirty, hungry and thirsty, but didn’t want to eat in front of the patients. I really just wanted a shower.

Pharmacist

The adults were also crowding round the desk, hoping to get their medicine sooner, although ultimately all they were doing was making the job of the pharmacist (who I later found out was actually a nurse, just doing his best) harder, and the whole process slower. He did come close to losing his cool once towards the end of the day, and to be honest I was full of admiration that it took him as long as it did. He and the woman sat with him were under so much pressure, in difficult circumstances. Long before the end of the day we ran out of paper envelopes, and he was having to fold up the tablets into pieces of paper. They are angels for the way they conducted themselves, and this was a one-off experience for me – these people do it every week.

The worst part of the job for me, were the containers I had to pour the medicines into. NHWC is a non-profit healthcare organisation, and couldn’t possibly afford to provide bottles for such vast numbers of people every week. And residents of Rhonda certainly couldn’t afford to pay for them. Therefore the patients provide their own used containers, which they handed to me when they collected their other medicines. Often these bottles were really quite dirty, and had clearly housed other substances beforehand. Some had been washed out with water, while others had not, but coming from a sterile-obsessed country like England, this was a bit of a culture shock. I felt upset that this medicine was going to be housed in such receptacles, and then given to children. One woman came forward with a plastic water bottle, and the pharmacist refused to authorise me to dispense the medicine. I felt sorry for her, but also relieved. For all we knew, she could’ve picked that up off the side of the road.

End of the Day

Towards the end of the afternoon we started to run out of some of the healthcare supplies, and a small number of people didn’t get their full prescription. They looked desperate, and I felt awful but this is no reflection on the NHWC, who do a fantastic job out here, completely free of charge. Without them some of these people would be far more ill, if here at all – it’s simply the sheer volume of people who show up. The authorities don’t even know how many people live in Rhonda, so there is no way of such organisations know how many people will come. We saw 364 people over the course of about 6 hours, and most of them took at least one medicine, if not several. It was a real relief when I saw that there were no longer people sat at the other end of the room waiting to see a doctor, as there was a time earlier in the day when it seemed that the line of people would never end.

A Quick Escape

As a footnote, as we closed down the healthcare clinic and drove out of Rhonda, it started to rain again. The staff were keen to get out of there quite quickly, and I soon saw why. It was a brutal storm, the rain really thrashed down for a long time, and the roads would soon get a lot worse. I was dropped off at my apartment, and immediately got into a warm shower to wash myself down. I love spending time with the children out here, but some of those children were very dirty and I was left feeling quite grubby. However, as I stood there I was left with a feeling of real sadness for these people, who had spent all day waiting to be seen by a doctor, possibly received some bad news, and then had to walk back to a home which was now being beaten down and washed through by torrents of dirty water. And there was nothing I could do for them.

That night I spoke to my parents for the first time since I got here and briefly talked it through. However the next morning I had my first proper cry since arriving; I woke up, burst into tears, and really needed it. But just saying that makes me feel guilty, after seeing what these people have to live with every day of their lives. And there’s very few people who can work their way out of it. I only hope the talents and smiles of Oscar and Mike give them an opportunity to do so, as they surely deserve it.

More soon x

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