Log Entry 10

Another week of mixed emotions. Yesterday we traveled by bus to Nairobi from Migori. We said our goodbye's to all of our new friends in Migori.  Migori had become our home away from home and it felt a little strange to leave.

Alice (left) and Marcelline (right). Alice was a mentor for all of us.
She is a clinical officer who works in anesthesia. She is applying
 to medical school and she will make an outstanding physician. Marcelline was
my house mom and took great care of me while I was in Bware and all of the students
while we were in Homa Bay.

This is Don and his son. Don was another clinical officer who taught
 us a lot while we were at Saint Joseph's Hospital in Migori.  Everyone found
 him to be very knowledgeable and you would be hard pressed to find a kinder man.

The tailor who made us all clothes. He is very good at what he does and is also very kind.

The sunset the night before we left Migori.

The same evening.

On Friday we had our final meeting with the community leaders in Bware. We ate good food, discussed our findings, exchanged feedback, and presented a few more gifts to the Bware community. It was a good meeting, with several instances where the ladies got up and started singing and dancing. 

I thought the seven hour bus ride back to Nairobi was about as pleasant as a seven hour bus ride can be. I always enjoy seeing the Kenyan countryside. 

Everyone is excited because this morning we all leave to go on safari at Masai Mara.  

Log Entry 9

Last weekend was bittersweet. Bitter because Lois had to leave us and return to her job and family in America. We will miss our new friend. She was such a great help in so many ways and full of excellent worldly advice.

Sweet because we visited Kisumu, a lovely town that sits on the bank of Lake Victoria. And for those biology majors out there I know the question burning in your mind is "Is this that lake famous for all the different species of cichlids?". Well, yes, but that's not why we came.

From left to right: Brandy, Amanda, Tiffany, and Jodee standing in Kisumu the night we arrived.

Our hotel was awesome. It had flushing toilets, hot showers, doors with deadbolts, and excellent mosquito nets.  One of the primary reasons we wanted to go to Kisumu was because of the rumors concerning a little hole in the wall there that makes real coffee (Tiffany and Amanda were hurting for some coffee). We were not disappointed.  In fact, even though I try to stay away from coffee most of the time, I thoroughly enjoyed an espresso milkshake (more than once).

Amanda was revitalized.

It's amazing the things you miss when you're away from home.

Fancy art on top comes at no extra cost.

Our second day in Kisumu was awesome. After our breakfast and coffee, we went for a boat ride on Lake Victoria. It was relaxing for the most part. Some suspected our guide may have been intoxicated already that morning, but the man operating the boat certainly was not.

On the lake we saw hippos and went to a part of the lake with tons of these yellow birds (I think they are called Yellow Weavers) making their nests.

After the boat ride we ultimately made our way to a place called The Impala Sanctuary. But this sanctuary had way more than just impalas.

The Hyena didn't want anything to do with us.

His name is Kijana, he is 9 years old and he eats 10 kilograms of meat daily.

Festus is the male cheetah in front, Alice is the female walking behind him.

Impalas walking around behind us.

Eve the leopard.

Annie, a lioness weighing over 200 kg (well over 400 pounds)! And Tiffany saying hello with the camera.

 

These little monkeys were hilarious.
They wandered around among the people and impalas.

Monkeys running towards some people offering to feed them (one of them appeared to be limping).

Mother and baby.

This is little Kimtai (a Blue Monkey) who enjoyed toying with the other animals.

Hippo yawning at a boat passing by.

We had a bit more coffee on the third day before heading back to Migori. The coffee place was called Ken's Shop.

We will miss you Ken's Shop.

Log Entry 8

When we aren't in the hospital or at local schools we try to have a little fun.  Saturday the 8th we went out to a town where they shape soapstone into art. Some were almost as tall as me and others fit in the palm of your hand. But they were all intricately made.  Again, we probably got overcharged (because we are foreigners) but everyone felt better about their bargaining skills this time.

Afterword, we piled into a car and went to a local restaurant/bar.

They learn to drive early here.

The Kenyan beer is called Tusker. Everyone enjoyed it.  The place we were at had a bunch of individual hut-like structures that you and your friends share.  They also had a tree house you can use.

Later we ordered a case of Tusker to have at home in case of emergencies.

Cheers!

Log Entry 7

During our first week in Migori after medical rounds I dropped by surgery with another student who is here (Peter) to see what was going on. It was Jodee’s week for surgery but she was kind enough to let me scrub in on an exploratory laparotomy. We don’t have access to CT scans here so the only way to know what was causing the peritonitis in this patient was to have a look inside.

Tools of the trade.

Ultimately the culprit turned out to be a ruptured appendix which we removed before checking the rest of the abdomen for pathology.

Ruptured Appendix

Me momentarily distracted by the camera.

Jodee had already assisted in an amputation that morning. This patient lost his leg to gangrene. He waited too long to come in to the hospital, otherwise the amputation might have been below the knee or even avoided altogether. 

After surgery I went by the lab again (outpatient clinic was not busy) and saw a positive Widal test. The Widal test is to check for typhoid (aka enteric fever).  

This person had typhoid.

 The next day Peter and I donated blood. I personally tested our blood. I checked hemoglobin, did blood typing, and checked for HIV, hepatitis B and C, and syphilis. Peter and I are both O- (universal donor). This means we can donate blood to anyone because our red blood cells have none of the major blood group (A, B or Rh factor) markers on their membranes for the other person’s immune system to recognize and attack. It also means someone who is O- can only receive O- blood because their immune systems will see the other blood groups as “foreign” and attack them. 

Donating blood at our hospital is key. Recently a patient in his 20's died because they could find no blood for him.  

Log Entry 6

Friday we split into two groups and went to local schools in Bware to deworm the children, as well as screen them for Tinea Capitis (Ringworm of the scalp) and anemia.  These were the diseases of most concern according to the community.  My group went to the Sigira school.  We found the majority of children had ringworm and several of them were quite anemic. The children we identified with ringworm and/or anemia were recorded and will receive follow-up. We left anti-fungal medicine at the schools so they can begin treatment.  FYI: Ringworm is caused by a fungus, not a worm as the name suggests.

Students at Sigira school.

The writing on one of the school buildings reads "Together we will defeat AIDS".

Friday night we stayed with our host families. They are very generous people that invite us to their homes and feed us delicious meals. Everyone had a splendid time.  The rural Bware community is a peaceful place to spend some time.

My host family's home.

Milking the cow.

Boiling the milk to make tea.

Log Entry 5

Today during rounds I saw patients with Malaria, Typhoid, and Stevens-Johnson Syndrome to name a few. One good thing about this rotation is that we get to see medical conditions that we aren't normally exposed to. Another thing is that after rounds I spent a few hours in the laboratory learning about and conducting various tests. I got to type and cross blood for surgery, I saw malaria under the microscope, tested for HIV, hepatitis B and C, and tested for fungal infections in blood samples. These are tests that clinicians normally just send out to be conducted and I think it is becoming a lost art amongst clinicians.

The very helpful Nora, who taught me many things in lab today.

Tobias, a kind staff member who donated blood today because the blood bank was empty and a patient needed to have surgery.

This is after mixing a patient's serum with potential donor blood. This blood is safe to transfuse to the patient if necessary. FYI: it is difficult to take a picture of a microscope image with an I-phone.

Alfred. A very knowledgeable and patient man who also taught me many things today, including what malaria parasites look like under the microscope.