First days

July 5^th

0900

We arrived late last night after our marathon day of flight from Seattle to Paris to Nairobi. Our total flight time was just under 17 hours between the two flights. Arriving in Nairobi was the same experience as in the past – stand in line for close to 1 hour to get our visas, then the quick chaos of gathering our luggage and medical supplies that we were transporting, the customs. The customs woman asked for our declaration form. We didn’t have one filled out (don’t remember that from before) so she just waived us through – “nothing to declare”.

Today we are going to visit two of the three major slum areas of Nairobi – visiting several churches and their accompanying schools, and a few clinics and a hospital in the slums who are friends, Gideon and Mwix, readily admit are shocking to see due to the extreme level of poverty. Having worked at Kijabe, which is a pretty decent facility for the developing world, I am curious to see how these conditions strike us. Having travelled in Haiti and Nepal, and having grown up in the rural areas of the Philippines, I wonder how these massive slums will strike me. Tomorrow we head to Kijabe, which I am looking forward to with great anticipation.

1800

Our day of touring the slums with Pastor Alfred and Moses was a progressive tour of more and more desperate conditions that over 1.5 million Kenyans live under in Nairobi. The densely packed mud and tin “houses” line the dirt footpaths and roads that weave through these giant slums. We first went to Kibera – the largest slum in East Africa to visit the Tumaini school and clinic run by Nairobi Chapel. The clinic was a simple structure with a waiting room, 4 exam rooms and a small lab. It was staffed by an RN and 3 support staff but was only seeing about 30 patients a day – the limited services they could offer were being eclipsed by another clinic nearby. Still, the poorest people would likely end up here – for prenatal care, skin infections, pneumonia, and malaria primarily.

The second slum we went to was Kawangwari – a smaller slum but poorer conditions overall than Kibera. Here we went to Paster Alfred’s school – about 80 children from ages 4-9 (Pre-K to 3^rd grade) packed into a single room metal shack that was about 30 x 20 feet in size with 2 doors and one window. The only semblance of school materials were a few pencils and each student had their workbook – a booklet of lined blank paper wrapped in newspaper to protect it. They sang of several greeting songs and were amazingly enthusiastic in their singing. These kids come from the impoverished neighborhood that surrounded the school and without education, their chances of leaving the slum during their lifetime is zero. There was one girl in particular who looked to be the one of the older girls – strikingly beautiful smile and fully engaged with our visit- that made me wonder where she would be in 10 years. The most likely place she would find herself would be still here in the slum, probably with a baby in tow, eking out a living with barely enough to get by. The HIV rates in the slums are much higher than in the general population, so the death rates and chance of living past 50 is low.

The last slum we went to visit was Muthari – the place that everyone says has been written off. It was controlled by a gang for a long time until the government came in and killed about 40 of the gang members and broke up their control of the slum. The problem is that now the slum has no organization at all – the degree of poor sanitation was profound – piles of stinking garbage, human waste and sewage water were everywhere between the mud-walled, tin roofed homes. Our friend Moses runs a daycare and church in the midst of this desperate slum scene. He has a vision of starting a micro-business with some of the teens here and creating jobs and a way out of the slum. On Sundays, when they have their church service, there are over 100 young people and children packed into a 15 x 15 foot room. It is a hip-hop service – lots of music, drums, and electric piano – somehow all done in this microscopic space. Moses and Alfred are amazing examples of the young men here who have dedicated their lives to trying to make a difference in the lives of young Kenyans with little chance of leaving the slum without their help.

6 July 2010

We headed off from Nairobi this morning to Kijabe. We said goodbye to Gideon and Mwix and loaded up our gear into the van. Jonathan from Samaritan’s Purse drove us out to Kijabe after our food shopping extravaganza at the Nakumatt store. Buying food for 6 people for a good portion of a month was quite a production but true to form, Peg and her mom, Faye, had “the list” and we were in and out in about 30 minutes. Kijabe is such a contrast to Nairobi – plenty of people walking the roads in this little village but in strikingly beautiful mountainside that overlooks the Rift Valley. We settled into our spacious apartment with a fabulous view of the valley out of our living room window. Charles Nelson, one of my senior residents, arrived just before we did and he and I did a quick tour of the hospital, got our pagers, and met some of the staff. I ran into a number of the nurses I worked with in the past, Jane in GYN clinic, Martha and Mary in the OR, and Esther on the men’s ward. Looks like Charles will be on the women’s ward this month, I have the men’s ward and we’ll be doing call together (which is bunched up at the end of the month for some reason). More tomorrow after the first day picking up team’s patients and seeing what I have on my plate.