Sunday, November 25, 2007
Hands to Work
Dr. Nan Hardison met me at Kisumu Airport in the "new" Maseno Missions van, after triumphing over a recalcitrant second gear. We delivered my bags to Rotary House, the hospital dorm, just in time for me to be able to join Dr. Gerry Hardison and his mobile medical team on a visit to Esiandumba, about a half hour's drive from Maseno. There, in a country churchyard, hundreds of children and their caregivers were gathering for weekly lessons on a propped-up chalkboard, a medical clinic and an orphan feeding program.
"Listen," Gerry said, handing me his stethoscope. "Left upper and lower lobe crackles, " I responded, as he wrote a prescription for an eight-year-old with pneumonia. There is surely hope for the child, but his mother's vacant eyes told another story. Of her six children, only two are still living. They clung to her as she was examined and treated -- young, pregnant and with no ID card to access prenatal care elsewhere. "Poorest of the poor" was written on one page of the patient's chart. "Saddest of the sad" was written all over her face.
Kids and their caregivers quietly responded to the gentle probings of the doctor and his staff. Busy chickens and pint-sized cats scurried in and out of the examining room, oblivious to our human intrusion. An axillary thermometer (along with Gerry's "magic stick," a Centrigrade/ Fahrenheit cheat sheet pasted on a tongue depressor), a stethoscope and a listening heart are the primary diagnostic tools in evidence.
Malaria, TB, HIV, meningitis, pneumonia, sepsis, tinnea, diabetes, hypertension and fever are among the many conditions seen, treated and followed, along with the chronic aches and pains of arthritis and bursitis, related to patients' years of carrying heavy loads. Malaria alone kills one million children a year, most of them under five and most of them in Africa; it is estimated that 200 out of 1000 children here will not reach their fifth birthday. Malnutrition, dehydration and AIDS-related opportunistic infections kill countless others. Patients are seen until there are no more at any given Saturday clinic.
Meanwhile, the "Mothers' Union" guardians (most of whom are elderly neighbors, aunts and grandmothers; the mothers, too, are dead), who had been cooking all night over open fires, were teaching and playing all morning with the youngsters of the parish as they awaited a hot meal which was, in many cases, the best or perhaps the only one of the week. The children lined up silently to wash their hands, then lined up again to receive their food. There was surprisingly little sound except coughing; the kids were sick. We prayed together before sharing a meal of rice and beans -- some of us without utensils and all of us without napkins. The custom in Kenya is to use the right hand to eat food, before and after which everyone's hands are graciously washed with water pitcher and bowl. Following lunch, we departed for afternoon rounds at the hospital. There, two new admissions were awaiting, and several other people needed follow-up care.
Panga (machete) wounds, burns, salmonella, post-matatu (-taxi) accident fractures, suspected TB and infections secondary to HIV/AIDS were among the presenting problems. Happily, however, one five-year-old child was being discharged. HIV-positive, he will soon begin antiretroviral treatment after his two weeks of successful anti-TB treatment. A grateful mama was so relieved that leukemia had been ruled out, she joyfully exclaimed to the doctor, "I will bring you a goat the next time."
Bedtime came early Saturday night. I crawled under the mosquito netting about 8 PM, the third time the electricity went out. My housemates, three medical students from Germany, a college student from Nebraska, and a pediatrician from Children's Hospital (and the Diocese of Massachusetts' Jubilee Committee), stayed up to exchange photos by candlelight since they'll all be leaving Monday after several months here at Maseno. Four, plus a visiting priest from Pittsburgh, will climb Mt. Kenya before returning to their respective homes. Please keep Bena, Rhiannen, Tilo, Josh, Christiana and Zach in your prayers as they travel.