To assist the material health needs of the clinic community, S.H.A.R.E.
members traveled with donated medical supplies (pharmaceuticals, diagnostic
tools, etc.). Clinics in these rural areas lack many supplies such
as stethoscopes, blood pressure cuffs, bandages, gowns, disinfectants,
thermometers, and antibiotics which are readily available in any clinic
or hospital in the United States. The first expedition in 1995 discovered
the lack of these supplies in addition to Bonyo's knowledge of health care
in this region. Mary Willy, a third year OUCOM student and member
of the 1995 expedition, was key to helping Bonyo organize the second trip
and prepare the 1997 team for what they would see in Kenya.
Living quarters were established in Kisumu, Kenya and travel was often arranged in advance. Taxis or mutatus (form of public transportation) transported group members to and from clinics to living quarters or even to Bonyo's village. Living in Kenya with local villagers for three weeks, members gained much cultural exchange, enabling them to gain access to another culture's world view in addition to learning about rural and tropical medicine, health concerns, and social problems. Though tribal languages (Luo was commonly used as the tribal language in this area although Swahili is the national language) are predominantly spoken, health care workers and volunteers in the villages know English and many offered to serve as translators.
Students worked to raise funds to cover in-country work-related travel
expenses, for the purchase of additional medical supplies as necessary,
and to cover any costs directly related to the purpose of our journey.
Students and members of the team paid for their own travel expenses to
and from Kenya as well as living arrangements and food. The group
consisted of approximately fifteen medical students, three doctors of osteopathy
(Dr. Neptune-Ceran, Dr. Daniel Marazon, and Dr. William Novelli), two nurses,
two counselor education graduate students, one organizational psychology
graduate student, an emergency medical technician, two premedical students,
a team of 5 medical entomologists, and several volunteers for a total of
about 30+ team members.
Kenya has been politically independent from Britain for 30 years and has demonstrated political stability. As tourism plays a major economic role, it is on friendly terms with western countries, including the U.S. During the team's expedition, much political chaos took place. For example, Kenyan nurses who are employed by the government were carrying out a strike to earn an increase in wages. They could often be seen on strike in Kisumu. Some riots related to the strike occurred in larger cities, but were not reported in Kisumu. Elections planned for December 28th brought political rallies and violence at times, although no one from S.H.A.R.E. Kenya became involved or felt threatened. Threats appeared to be maintained within political groups who maintained animosity between themselves.
For links to more information on Kenya or East Africa, try one of
these links.
S.H.A.R.E. Kenya II was supported by Dr. Barbara Ross-Lee, Dean of
OUCOM; Lois Kiss, Associate Dean of Health Policy at OUCOM; Kathleen Mosely
of student services; the group's advisor and head physician, Regine Neptune-Ceran,
DO, who is a member of teaching faculty and general surgeon at O'Bleness
Hospital, Athens, Ohio; Joseph Burick, DO, private family practitioner
and NEOCOM preceptor; and Dr. Alibhoy, M.D. who resides in Kisumu, Kenya
and was educated in Great Britain. The minister of health for the
district where we worked, Dr. Muga, also served a large role in coordinating
our service for the rural community.
Ahero Health Clinic and Aka Khan Hospital
Once we established living arrangements and gathered an understanding of the nurse's strike, we focused on one public rural clinic, the Ahero Health Clinic, and a private hospital in Kisumu to which Dr. Alibhoy is associated. Two to three medical students rotated at the private hospital observing doctors working there while the other medical students set up stations in available rooms in Ahero: three general medicine rooms with two medical students seeing patients in each, one observation/emergency room for urgent cases like wounds or cholera, one pediatric room with two medical students, and one OB/GYN examination room with 1-2 medical students. Each room had one other non-medical student when possible (i.e.-a graduate or premed student) checking in patients. Medical students verified their diagnoses and treatments with a D.O. or with the head of the clinic, Dr. Juanita Hongo, who was trained and a native of Kenya.
Patients requiring medications were directed to the pharmacy where they are commonly charged 20 shillings, however, S.H.A.R.E. waived the pharmacy cost for patients during our stay. Dr. Daniel Marazon, D.O. oversaw the pharmacy, usually working from 7 or 7:30 am to 6 or 6:30 PM. It soon became apparent that we needed to organize the droves of people who wanted to see a doctor, and several persons from the team developed a numbering system each morning. Lines often began forming at 5 a.m. or earlier. Members of the team began seeing patients as early as possible and stayed until the last number was seen if possible, often as late as 6 or 6:30 at night (when it became too dark to see by one low wattage light bulb). Others arrived on-site early to set up, organize lines, or as in Dr. Marazon's case, he administered children's Tylenol to kids with high fevers early in the morning since many mothers would need to wait most of the day to see a physician.
Our efforts were more complicated with the lack of nurses who perform
many services in Kenya, including laboratory tests. Diagnoses, therefore,
were mainly made on the basis of clinical observations. For example,
simple malaria smears could not be done without the nurses, so physical
symptoms, vitals, and palpating of the spleen carried much weight in diagnosing
malaria.
Medical Diagnoses and other Successes Encountered in Ahero, Kenya
One child who attended the Ahero clinic was discovered to have a large abscess which had infected the bone, causing necrotic tissue to grow over his hip joint. He was carried into the clinic by his father who showed the x-rays to Dr. Hongo and Dr. Neptune-Ceran, D.O. He needed an operation to remove the necrotic tissue and the abscess. The team had enough funds to pay for his operation. Due to this operation, his leg was not amputated. Upon our departure, the little boy was healing well in a Kisumu hospital, Aka Khan.
Also during our stay, three healthy babies were born, children and adults with cholera were treated, hundreds of cases of malaria were seen and treated, scabies, malaria, sexually transmitted diseases, diarrheal infections, worms, upper respiratory infections, fungal infections, and a variety of other complications were seen. HIV was possibly seen in several cases, although confirmation of this diagnosis via testing could not be made to verify this.
Needless to say the group members experienced much cultural exchange
and medical experience in Kenya. In addition to aiding the health
professionals and Kenyan communities, the experience will make a lifelong
impact on the medical student volunteers. Many of the experiences
are simply to amazing and overwhelming to explain, no matter how graphic
the media.