Still lots to do!

Catherine1 Posted by Catherine McKnight on Thu, 07 Jul 2011 | 4 comments | Bookmark: digg this Post this to Post this to Facebook

It’s been a while since I’ve written anything, and there’s a lot I could tell you about, but first I want to say thank you for the support and encouragement I’ve been receiving. There have been a couple of teams from Ireland here in Kajiado – St. Paul’s, Lisburn and Limavady Grammar School (who are still with us). I’ve been overwhelmed to hear of the number of people who follow my blog and eagerly await new updates – it’s a little humbling now I realise how long it is since my last update!

Since I last wrote, we had a meeting about the clinic’s lack of funds and the desperate need to buy medication. After some serious discussion and review of our budget, we were fortunate in being able to borrow money from another department within the diocese in order to buy medicines. With our pharmacy now well stocked, we are able to provide a much more satisfactory service to patients, and, of course, to generate some income.

We have also purchased a generator with funds generously donated by Sion Mills and Urney Parish vestry. This has been a great addition as it allows us to continue doing lab tests and have access to medical records when the electricity goes off. Previously on the days without electricity, we would have fewer patients, because they knew we couldn’t make some diagnoses without doing lab tests first. Hopefully now that we have the generator, and word gets around that it’s here, patients won’t have to think twice about coming to our clinic on days without electricity.

In the clinic, we continue to see an increased number of patients, and we are also looking at other ways to promote our services. There is an international charity called Compassion that aims to improve the health and education of disadvantaged children in a number of developing countries including Kenya. Every six months or so, the children undergo a health ‘screening’, during which they are seen by a doctor, offered treatment if necessary, and recommendations are made for onward referral of more complex health problems that may be identified during the screening process. A few places around Kajiado have Compassion projects running, some with 50 children, and others much larger with up to 250 children. We have been involved with Compassion in Isinya and Ngatu. In Ngatu we saw over 200 children in the one day – it was certainly a tiring day, but I hope we also reached out to each and every child with provision of both loving care and health care. This was an interesting experience in a relatively remote community, and highlighted common problems facing the children such as malnutrition, worm infestation and poor dental health. These are a reflection of the standard of living – with reduced access to health and dental care and both the availability and affordability of adequate nutrition.

I am also about to start working with the local hospital and hope to be seeing some in-patients there. I have missed the more intensive care and continuity of working in a hospital paediatric ward. Kajiado district hospital has paediatric in-patients, but no paediatrician or dedicated children’s ward (they are admitted to the female wards). In fact, there is no paediatrician in the whole of Kajiado district – a population of about 400 000 people. I have been trying to arrange this for a while, and had hoped to start sooner, however, my medical licence to practice here needed to be amended by the ministry of health. I have seen at first-hand how the speed of working here and communication between office departments can be somewhat slow and hence frustrating. I was therefore very relieved the day that I finally collected my letter amending my licence to practice! What I hope to do, under the supervision of the district hospital medical superintendent, is to do teaching ward rounds approximately once per week – seeing the children and advising on clinical management while also teaching the staff as I go along. Thus benefitting the children currently admitted, but also making the staff aware of what to do in the future for similar cases.

Unfortunately the day that I was pleased to collect the letter about my medical licence, I also visited the immigration visa office to renew my visa – they politely declined to renew my stay here any longer. I am using a tourist visa and officially it should only be renewed the once. Ronnie had happily reassured me that I should have no problems renewing it again, telling me the record number of times he’d heard about it being renewed was twelve! After failing to persuade various members of staff in the immigration office at a number of different counters – alien registration, visa renewal, work permit, etc. it became apparent that I would have to leave the country. So I ventured off to Tanzania, crossing the border in the hope that Kenya would let me back in. In fact it was so easy, I wondered why they had made such a fuss in the first place. 100$ worse off mind you – 50$ for a Tanzania visa, and 50$ to get back into Kenya! Anyway, I wasn’t too upset by it, thinking perhaps it’s a sign that the offices are becoming more accountable – I’m sure lessons have been learnt from their colonial forefathers when I imagine how difficult UK immigration must be!

The signs of progression here are encouraging and I’m friendly with a minister called Reverend Eric Solonka, (who some of you may know from his visit to Ireland a few years ago), who is an avid campaigner for progression among the Maasai community. He has a parish with twelve churches, in what is known as Maasailand – the rural area beyond Kajiado. Here is where the differences between our cultures are readily seen. There are many good things about the Maasai community and their cultural practices, but many things cause hardship and with a little foresight and planning, could be eased. Many Maasai families have a large number of cattle, which are worth a lot of money – a large bull could be worth about £1000, but they live in basic manyatta homes – where the walls are made of sticks and mud, and the roof from dried grass, while sleeping on animal hide stretched between sticks. Not exactly what you would call home comforts! With their assets dependent so much on cattle, they are loath to sell them and are vulnerable to droughts and famine.

It is also startling to note some statistics about the girls in the local community – in this particular community, only 10 girls have ever completed their secondary schooling. This being a reflection of the practice of girls being married at an early age – often to an older man, and not always as his first or only wife. As a girl, it makes me realise how privileged I was to receive the education I did and to be brought up in a community where girls have more control and independence in their own lives. The education of girls is so important not only from a learning point of view, but it has also been shown to be directly linked to improved health care and improved child mortality rates. Understandably therefore, improving the education of girls is a millennium development goal – goals which have been devised by the World Health Organisation and are being supported in developing countries by a number of different organisations and projects.

Last Sunday I went to one of Reverend Eric’s churches in a place called Orpirikata. The church has been meeting underneath a tree for the past twelve years, the seats are made of sticks bound together and the lectern/pulpit is a wobbly piece of wood on top of a longer log. (Have a look at the photos!) The faith of the people there is palpable and it is good to see how a ’church’ is the body of people not the actual physical building, but on the days when it is windy or raining, then no-one comes to church. So after the service there was a fundraising to raise money to build a church – nothing fancy, just a simple wooden frame and corrugated iron roof and walls. It’s amazing to think that for twelve years they haven’t managed to raise enough money to fashion together some sort of building, but it’s all in God’s timing, and that day, with the help and support of the local community and other nearby churches, and the generous donation of land by an old ‘mzee’ (Swahili for old man), they have raised enough money to build a church. Just imagining the difference a roof over their heads will make is amazing and hopefully it’ll mean that every Sunday, church is a place they want to go to and in which there will be a little bit of comfort and welcome.

My time here continues to be enjoyable and blessed by good health. I’m enjoying speaking Swahili now and it’s great to see how far I’ve come. I’m starting to think about coming back home – although I reluctantly use the word ‘home’ as I feel very at home here in Kenya now! I was tempted to extend my time off from work, but after a rather emphatic ‘no you can’t!’ from the doctors in charge of my training back in the UK, I realised that I should come back and complete my paediatric training for the remaining three years. During which time, I hope to plan how to come to Kenya in the longer term. When I come back, I’ve heard that my placement will be in Luton and Dunstable hospital. This isn’t commutable from my house in Ely and so means I’ll have to start thinking about accommodation in Luton – not an easy task when I’ve only got a couple of weeks back in the UK before actually starting work. It’s hard to be thinking about planning things back in the UK while I’m still enjoying things so much here!

I’ve only about six weeks left here and I’m hoping time doesn’t fly too quickly as there’s lots of things still to do!


Elizabeth Hanna said Fri, 08 Jul 2011 12:24PM
That was so interesting to read. Thanks.
Rashmi said Fri, 08 Jul 2011 01:25PM
That was very interesting, Thanks Catherine..
Jill Maxwell said Fri, 08 Jul 2011 04:34PM
Catherine, as ever an interesting and humbling read. You continue to be in our thoughts and prayers. Jill, Phil and Sophie
Tracey, Jed, Benjamin and Theo said Sun, 21 Aug 2011 06:50PM
Hi Catherine! Thanks for your update, good to hear you are well and still in Kenya, God is good! Thinking of you at this time as your work there comes to an end. Love and prayers, Tracey, Jed, Benjamin and Theo xx

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