Greetings from the Sausage Tree

Well , made it to Kenya with relatively few problems. We missed our flight to Eldoret because we went to the wrong airport in Nairobi but caught the next one later in the day without any issues other than spending a long boring day in the Nairobi airport. We arrived in Eldoret yesterday pretty tired. We’re staying at a compound here called the IU House which is like a pretty nice dorm actually. Jen and I are sharing a medium sized room (named the “Sausage Tree” and have our own bathroom right outside the door (hot shower and everything though the water pressure is low). We had our initial orientation and spent the morning at the hospital today but then have had the afternoon off to get ourselves settled. Honestly, even just the morning made me exhausted. I think it’s a combination of the jet lag, the altitude and being in a new place and situation.

One thing I’ve been struck by here is the rampant discussion of Obama. As the election happened last night (Kenya time) multiple people stayed up through the night to watch the election results come in on CNN. I asked one of the Kenyans watching the election results what would be the benefit for Kenyans if Obama was elected and he answered, “we’d get a national holiday.” And he was right, Kenyans today are so happy that they have actually declared tomorrow a national holiday. That’s right, election of someone not actually from Kenya, not in their country has had that effect. One of the other Kenyans thought that it would be easier for Kenyans to get VISAs into the U.S. I’m not so sure that will be the case but I didn’t tell him that. People are so excited, there is even a reggae type song getting a lot of radio play called “Barack Obama.” If you’re into that sort of thing, you should google it and check it out, it’s pretty funny. The irony of this whole situation is the people of this country seem to be so proud that both a Kenyan and an African American is going to be president of the united states. However, if you look at the record, you see that Obama’s Kenyan father abandoned his family leaving a single white American lady and her white parents to raise him in the United States. So essentially, other than some sperm donation, how much did Kenya really have to do with him??? Just some thoughts (that I’ve kept to myself while here) …

Today at the hospital was interesting to say the least … there are about 48-60 Pediatric patients in 8 bed wards with beds being about 2 feet apart. There are no monitors, minimal medical equipment and disorganized or absent charting. The intern and the resident pretty much run things with attending physicians showing up a day at a time or not at all. I’ve been assigned to a team with a Kenyan intern (someone who’s had 6 years of medical school after highschool), a Kenyan Resident (someone who’s had training up through Intern year, then practiced for a number of years but is back to specialize), and a 4th year medical student from IU who seems vastly more knowledgeable than the Kenyan Intern. I did feel like the Kenyan resident was pretty competent, however. We cover 12-15 patients on our team. After we were done rounding today, one of the babies on the other unit stopped breathing and required some basic resuscitation. As we watched the infant required bag mask ventilation, became minimally responsive and started having some extensor posturing. The infant started breathing on her own again but with shallow breaths. They have minimal ICU beds here and really only intubate people that they feel very confident will be able to come off the ventilator because, culturally, they don’t withdraw support once they’ve given it. I believe this infant probably is septic, if not encephalitic (blood stream infection and infection in the brain) but so little was able to be done for her. We left her in a state such that I will be surprised if she lives until tomorrow. Its just such a different system and I’ve been encouraged by both people who have gone and people who work here currently to watch and observe initially and then try to contribute as I understand the system better. But ultimately, this system functions with or without us and there are many, many limitation which will not change by my presence here. I have to look at it as anything I can contribute with my limited knowledge is a bonus but not get too involved in taking ultimate responsibility. I sure have a lot of thinking and learning to do and will try to update this once per week to tell you what I’ve seen!