By Lt. Cmdr. Andy Baldwin, Family Medicine resident, Naval Hospital Camp Pendleton, Calif. Lt. Cmdr. Baldwinis participating in a month long rotation in Western Kenya as part of his Family Medicine Residency at Naval Hospital Camp Pendleton, Calif.
The Kenya Ministry of Health designates health care facilities by their ascending level of care starting with Dispensary, then Health Center, then Hospital. Whether public, private, or faith-based organization funded facilities receive these designations.
Shortly before I arrived in Kenya, the Chebaiywa Health Center went from a designation of Dispensary to that of Health Center. This marks an impressive milestone to achieve in less than five years. It is a reflection of the hard work and dedication of the director, Michelle Kiprop, and the lead staff of the clinic who have put in expanding the clinic’s reach, resources, and capabilities.
One way a clinic such as Chebaiywa raises awareness, spreads good will, and improves the health of the community is to do humanitarian outreach visits.
Many experiences I have had as part of U.S. Navy Medicine’s Global Force for Good are centered on this humanitarian assistance outreach model. So when MIchelle Kiprop asked what I did best as a Navy physician, I told her I liked to get out in the community doing public health education and visiting rural areas providing health care. Last week here in the Rift Valley of Kenya, I had the opportunity to do both. It was exhausting work, but very rewarding and effective.
This is how it came to pass. Last year, Chebaiywa Clinic’s Optometrist Kimboi had passed through a rural village named Ziwa about two hours away by car. He stopped for a cup of chai tea and started talking with a villager who happened to be one of the pastors at the village’s church. After hearing that Kimboi was an eye specialist he reported that for several years now he could not see when he tried to read the bible. Kimboi happened to have some glasses in his vehicle and was able to outfit the man with reading glasses and voila, the pastor could see again! The pastor was so taken by this gift and his renewed sight he invited Kimpboi to return to the town with the rest of the medical team in order to evaluate all of those in the community. He said that the medical team could use the large unfinished village church as a treatment area.
Upon my arrival in Kenya, we worked towards setting up this outreach trip. Cards with the address and directions to the Chebaiywa Clinic were printed and distributed. Eyeglasses of various prescriptions were stockpiled. Common medications were assembled. Dental extraction devices were packed. The church pastor was contacted, and posters were put up around town advertising our team coming. It felt very similar to planning logistics of outreach missions when I was on the USNS Comfort as part of Continuing Promise 2009 in Central and South America. We were ready to go, but one issue remained. We had no way to get there. The Health Center does not have a vehicle/ambulance/van of its own to transport patients to the clinic or the hospital or to do these outreach missions. This is a major limitation and I urge people to donate if you can give even a little to get this much needed resource. It will help save many lives. At the last moment, we were able to convince the Children’s Home Orphanage driver to take us there for a hefty fee.
We piled into the rickety van early on a Friday morning, and we were off to Ziwa! Several hours later after a few wrong turns and stopping to ask random passersby where Ziwa was located, we finally made it to the town and tracked down the unfinished church. The Pastor and several area elders (they call them Muzees) were there to greet us. They talked only in the local tribal tongue of Kalenjin so I definitely had no idea what they were saying. Yet I could understand the body language and it was clear that Kitur, the head nurse from the Clinic, was a bit annoyed that there was a large church but empty with no people to be seen. Had they forgotten to put up the posters? No, the Pastor said, but perhaps the people did not understand. We huddled and decided we would drive into the village, get some chai tea, and troll for some business. So we piled back into the vehicle, I made sure to wear my white coat, and we drove down the dirt road to the rickety shacks of downtown Ziwa.
The village was full of people carrying on their daily business of herding cows and goats, transporting items on backs of donkeys, making sandals out of tires, and doing maintenance on vehicles. All eyes turned when we emerged from the vehicle and Kitur started to tell people to go to the church to get eye care, teeth care, and to see a “Muzungu Daktari” (white doctor from America). Word of mouth quickly spread with giggles of the children and stares of the people intensifying. We were definitely remote as judged by the reaction of the people to a white person. The Kalenjin tribal influences were definitely more evident as well with beautiful colored fabrics being worn on the bodies and heads of the women. Also, both men and women had earlobe holes incredibly stretched out. Some earlobe holes were so stretched that they would flip the hole up on top of their ear to keep it from flopping around so much. We returned to the church, and set up shop. Kitur and I were in charge of seeing any medical patients, doling out medications and eyeglasses. The dental tech would do teeth extractions. The nurse midwives would check in patients, write down chief complaints, and take blood pressures. The church that was empty just an hour before was now filling with people. We worked tirelessly throughout the day seeing patient after patient, many with the same last name but of no relation. There are such common Kalenjin names, in their minds they are all related. I struggled to understand the language, but quickly became fond of the word “Oye”, pronounced as the latter part of the word ‘boy’ would sound. In Kalenjin, this means Okay. So I would say “Oye” and if I got a smile or a similar response, all was good.