Going Mobile

After doing health outreach in the Denver metro area for 5 years I was anxious to see how it was done in rural Africa. On Tuesday Paul and I got the chance to ride along with the mobile team to the village of Arombe. The team loaded up one of Lalmba’s Land Cruisers and hitched a trailer on the back filled with bags of maize to drop at a village along the way. Nine of us squeezed into the vehicle and set off. Our first stop was at a “hotel” which is what the Kenyans call a small restaurant. The staff there knew we were coming and had prepared a sweet chai tea and fried bread. The bread was similar to the pizza frite my dad would often make and the tea was milky, hot and delicious.

A half hour later we were again on our way 4 wheeling over dirt back roads and through rain swollen fields. Paul and I got the honor of sitting up front next to our driver and director of education, John ChaCha. The other six were being tossed around in the back but had a great time talking and laughing together. It was like being at a Roseto family gathering with everyone talking at the same time. Add some Kenyan music that sounds akin to Mariachi music and you have a picture of our trek.

As we came through a clearing we saw our outreach site- a long stone building. Inside were 36 adults listening to a Community Health Worker (CHW) talking about infant nutrition. As she fielded questions we set up to do antenatal and well child exams. One corner was cordoned off with a huge tarp for antenatal exams. I joined the clinician, Moline and a health educator, Mazeline behind the drape. First, Moline asked questions about the woman’s past and current pregnancies then had the patient crawl up on a wooden table for her exam. There we checked her BP, listened for fetal heart sounds and measured the approximate size of her womb. The women were often accompanied by the local TBA (traditional birth attendant) who would be with them for their home birth. She was a warm, middle aged woman who had a caring and wise presence about her. I thought how much comfort she must bring to the laboring women.

While we were seeing the pregnant women, Paul was helping some of the team see the babies and toddlers. They threw a rope over a beam to hang an old fashioned grocery type scale with a sling. Each babe was carefully weighed and then given the needed immunizations (IZ). The Kenyan IZ schedule is greatly abbreviated compared to ours in the US. They receive 3 doses of oral polio, and of a pentavaccine (DPT, Hep B, HiB) and one dose of BCG to prevent TB during the first 2 years of life. The staff also give out infant Tylenol and vitamins, laundry soap and prenatal vitamins.

The mobile team was assisted by 2 elderly gentlemen who told me they started the first mobile site some 20 years ago. They asked if we knew Bob and Gruffie who were instrumental in starting the clinic some 23 years ago and are still fondly remembered by many, many people in the area. We were happy to report that we did know them and would pass along their greetings. They then asked us to take their picture and to have it printed for them, if you please. I was happy to oblige although I’m not sure how I’ll get the prints. I may have to have them sent from the US. At any rate, it was a fun, interesting and highly successful outreach.

The rainy season hit full force this week. It started raining last night and continued through the better part of today. It seemed like a monsoon type rain, or maybe hurricane level without the winds. Anyway, a BUNCH of rain fell in a short amount of time. It flooded the upper compound where some of the clinicians have homes causing water to flow into their living and cooking areas. We also learned that patient attendance is inversely proportional to the amount of rain we receive. This morning the rain was so fierce that all our patients stayed home. Paul, Jeevan and I stayed in our cookhouse and had a brain storming session while our cook Joyce baked spice cake. It felt a bit like being at summer camp.

Without the sun shining, within a day we’re without electricity. My electric toothbrush is dead (a foolish thing to bring to Africa but my dentist would be proud), our computer is running on battery but the screen is getting dimmer and dimmer, and we don’t have cell phone service so no internet connection. The guy who makes the $100 computers that can be powered up by winding a handle knew what he was doing.

Earlier in the week we went walking and met a young woman heading to the lake with a tub full of dishes on her head. She spoke English very well and told us her name was Judy and she was 12 years old (she looked 18). She asked our age and when we told her she exclaimed “It is a lie!” We assured her it wasn’t. She again expressed disbelief. (Was she being kind or were we the oldest people she ever met?) I asked about her mother’s age and she told me she was 30 but already dead. She had been killed by “some people”. We told her how sorry we were and Judy told us she has 4 siblings and she is the oldest. Her youngest sib is just 5 years old. Her father is…drum roll…80 years old ! Judy is most likely the care giver of her family. She said she was in 8^th grade so this may be her last year of school unless the impossible happens and she finds a way to go to secondary school.

As we were parting she asked us for something. Did she say pants? Pence? Pans? Finally she rephrased it. Could we give her some “writing implements”? Oh, pens! We were asked by Lalmba not to start buying for people or we would be inundated with requests. But I think that just this once we’ll make an exception and buy this special girl a few “writing implements”.