Post #7

#3: Shukri and Summaiya


Background: Shukri and Summaiya are both 6th-year medical students, which means they are in their final year of schooling before becoming interns. They are also among the first friends that we made living at the hostels, and since then, they have taken us under their wings. This was the most boisterous and charged interview I've had yet, and they are truly inspiring to me because it is their passion and dedication to medicine that shows that they, along with their peers, are the future of Kenyan medicine. I am straying from my typical interview format in this entry simply in an attempt to capture the flow of their exchanges.

Summaiya: I've always dreamed of being a doctor, but it can be frustrating being a medical student. It is frustrating, but rewarding too. When I went to the wards, I realized the impact students could have on patients. The story I always remember is of a 4 y/o patient named Sharon whom I met in my 4th year rotation in Peds. She had presented with multiple fractures and stab wounds, and she was clearly a case of child abuse. However, everyone was so busy that no one noticed, except for the medical student whose job it was to take detailed histories of the patient. Now in the US, you would probably get an x-ray and see old, healed fractures, or have a psychologist, but here, we don't have that. So it often ends up being the medical student who spends the most time with the patient, and when I looked into her story, I found out that she was being abused by her step-mother. But, even after this, it is frustrating since it doesn't matter; she still went home. This is an issue of culture, not government, since the government has given us community health workers, social workers, the Child Protection Act; but we need community acceptance that such things are happening and they need to be reported or addressed. This story is the reason I want to go into pediatrics.

Shukri: I don't really have a story that I remember since I think I deal with problems by forgetting. I actually ranked law school as my first choice in high school, but then I decided to pursue medicine, and I went to Poland to study. However, it was hard. There were five of us Kenyans in the program, and I was very homesick. Every day I would talk to my mom about coming home, and she would say, "yes, come home". I would then talk to my dad, and he would say, "no, don't come home". The NGO that was supposed to sponsor us didn't end up giving us as much support as they promised, so my parents were paying around 20K per month. Plus, once the money reached me, there wasn't much left after rent and groceries, so I felt like my parents were struggling for nothing. The language was different and not many familiar faces around. I became depressed, we all were. After that, I knew I had to return to Kenya, and when I did, I requested a transfer to Moi University School of Medicine, and they accepted me, so I came here!

But in Kenya, the working conditions are pretty terrible for doctors. It is nice in MTRH (Moi Teaching and Referral Hospital), but in the periphery health centers, there can be no gloves or antibiotics. Interns can work for 72 hours without sleeping.

Summaiya: Except for naps when you can. Plus, interns only get peanuts for pay. Then once you're a Medical Officer (MO) [like a resident], the government doesn't want you to continue your studies to become a consultant [like an attending] because you would have to leave and then there'd be fewer workers, plus they'd have to pay you. But then if you just want to find a job after your internship, they no longer place you randomly either, you have to apply. And if you apply, you will only apply to your home area or areas like that because counties will also only hire those of their own tribe.

Shukri: Counties and states were created after devolution happened [in 2010] in Kenya. Each area was given their own power to make rules, have their own governing body, and have their own funds. Health was partially devolved. This really helped some counties who used their money well, and they have progressed a lot, but for other counties that have local corruption, it really hurt. Plus now, doctors can't stand up and fight the government since the local government probably knows you personally, since it is small, and people could walk into the hospital and slap you. The government also ordered a lot of new equipment for the states to use, even before the states had personnel or training to run it. So a lot of the equipment is being leased and paid for, but just sitting in Nairobi, not being used.

Also, there are so many ambulances, but they're not maintained. If a patient needs an ambulance, they have to go to the county government, clear it with them, then pay for fuel…in fact, there was a patient once in Kisii who emergently needed an ambulance, but it wasn't available since a MCA (member of county assembly) had used it to transport the tomatoes from his farm.

Summaiya: See, the problem is not the central government. If you give the government a proper budget, they will accept! The issue is local corruption. The local government can say they're spending 100,000 shillings to buy a wheelbarrow, or 50,000 shillings to buy a pen. Like seriously dude? We'd be better off having one government handling the money and dividing everything equally.

Shukri: I mean, they can steal 20 million, we're OK with that. Not 300 billion!

Summaiya: The thing is we need to nip the problem in the bud. These big thieves come from being small thieves. Even at the university level, there are thieves, and students just accept it! Before, the hostels were clean and the toilets flushed. Now, there is no one to fix these things.

Shukri: They just say the university has no money. We don't even get printing anymore. Then if we don't pay school fees, they will come and take your mattress.

Summaiya: And as students, we accept this. We won't stand up together and hold the school accountable. We just want to finish and graduate without more problems, so today, they don't print our logbooks. Tomorrow, our toilets don't work. Then our projectors are gone. Then what? We are left with blackboards? Every weekend we don't have water at the hostels, but everyone is busy with their lives, so we just say "we can deal with it. It's just a weekend after all". We are supposed to be the voice of our community, and we can't even protect ourselves!

Even with the doctor's strike. Every year before the elections, the government chooses a sector to suck money out of for campaigns. This year it was health. Last election it was education. Primary school level kids were out of school for ½ year. For the doctors, we wanted more health infrastructure, more students graduating and employment, as well as higher pay. The public supported us in the beginning. But then it got twisted into how doctors just wanted higher salaries, and in the end, even my own family didn't support the doctor's strike.

Shukri: Mine supported me.

Summaiya: OK, well that's just you!

But anyways, every election year, everyone just points out the negatives about our country. But in the end, there are so many good things. Our country is amazing.

Shukri: Yes! We are so diverse. I remember when there was a terrorist attack by Al-Shabaab where they stopped a bus with both Christians and Muslims on board, and they wanted to call off all the Christians and kill them. Instead, the Muslims on the bus gave the Christians veils to keep the terrorists from being able to differentiate between them, and protected them.

Summaiya: The goal of the terrorists was to start a religious war between the Christians and Muslims, but everyone stood up and said all for one and one for all. That is one of the most amazing things about Kenya. During this time, our government even told the media to only show positive messages in support of one another. Heightened security checks based on religious grouping stopped, and by doing so, we stopped giving the terrorists power. We were unified. The media didn't capitalize on tension between the groups, which was obviously going to be there. We didn't give it power. We educated and loved.

Shukri: After the Westgate shootings too, the immediate relief response was so fast and so much blood was given that we ended up with enough to respond to the crisis, plus enough to store as extra reserves for the hospitals in the future.

Summaiya: At the end of the day, it doesn't matter what tribe you are in. If someone speaks out against Kenya, everyone is Kenyan together. "


Posted at 00:37

Post #6

#2: Sharon (Her message to Americans: We love the muzungus!)



Background: Sharon is one of the wonderful kitchen staff at IU House, and she was the first Kenyan I forced my friendship upon here in Eldoret. Since then, I greet her with a spastically excited "HELLO" every time I see her, and I'm pretty sure that on her part, she just deals with my shenanigans.  

"I've worked at IU House for 1 ½ years now, and I love it here. The environment and the company make it better than my previous jobs. I was born in Kapsabet town in Nandi County, and I came to Eldoret in search of a job. I worked in many hotels before coming to IU house, first as a cleaner, and then making snacks. The hours were long there. I have never been outside of Africa, but my dream would be to go to India. I love the food, the Indian people, their music, they movies, everything! I think that I would move there one day, God willing.

But for now, I live in Kipkaren. I love it there because it's quiet and near the town, the hospital, and the schools. I have three kids in primary school now, two boys and one girl. One in Class 7, one in Class 4, and one in Class 3. My dream for them is to grow up, get a good education, find jobs, and most importantly, to know God and serve God. Because my kids are young, I still have to make sure they study at least one hour each night, but one of them actually wakes up at 4AM every day to study! They want to be an accountant, a doctor, and a pilot when they grow up. Sometimes I want to keep them near me, but other times, you have to let them go for their betterment. Besides, if they achieve their dreams and become what they want to be now, I would be very OK with that.

I grew up in a small village with a big family. I had 7 other siblings, and I liked that a lot; it was fun! My parents own a farm where they planted tea, maize, sweet potatos, cassava, and more. My favorite job on the farm was plucking tea, but I hated weeding the maize. I've also learned to milk cow since I was very small, and yes I have been kicked [Yes I asked her this. Yes she laughed a lot]. I see my family maybe 2-3 times a year. My sister is also in Eldoret with me, and she is studying laboratory sciences. I wanted to study medicine when I was young, but it just wasn't possible for me. Here, kids who don't perform well go to college, and universities are the ones that have a higher level of education. Even the teachers there have a different education level. But there are not many scholarships available, and they only go to kids who perform well.

I think this accessibility to resources like schools and hospitals is a problem in Kenya. I think Kenya is the best place to be except for the politics. There is too much corruption, mainly, and misuse of funds. People don't prioritize what they do, and leave important things until it is too late. There are too many children learning under a tree, or travelling long distances to go to school. Some parts of Kenya don't even have water. We need to prioritize these places. The government should look at these places and build things there. Too often, people only look at their home place, and not beyond to all of Kenya. Something needs to change here. The candidates now are not really good. We just need candidates with the people's interest at heart, and we need people to stop voting for their tribe. Kenya is unpredictable, and I am not sure what will happen, but we Kenyans can fix our system. If we Kenyans stand against corruption, we can stop it."


Posted at 07:56

Post #5

As I face my last week here in Kenya, I am dreading going home and facing the ultimate question: "How was Africa?" I dread this question because where can I begin? Should I talk about how each and every day, I was mind-blown by the passion, drive, innovation, and collaboration that makes up AMPATH as a whole? Should I talk about all of the medicine I have learned through my time on the various wards of Moi Teaching and Referral Hospital? Should I talk about the amazing people, Westerners and Kenyans alike, that I've had the honor to rub shoulders with? I think that the only way to truly comprehend 'how Africa was' is to live it. So I want to bring a piece of it to you! Here's a chance to meet the amazing humans I've gotten to know here. I have taken the liberty to speak from their shoes, but I will do my best to stay true to the core of our conversations. Through my next few blog posts, I hope you can start to understand how my summer really was from the very people who have shaped it.

#1: Edward (Dream destination: Jerusalem, with his daughters, to see the life of Jesus)




Background: The one number I have on speed-dial here is to Taxi-Max (sounds like a plan!), the taxi company that allows everyone at IU House to function and travel places. Such places can vary from going to the hostels every night, to going to Maasai Mara for a weekend safari. Edward is a driver for Taxi-Max, and today while my team was travelling to Iten for our trauma research project, I asked if I could interview him for the blog. He had looked a bit taken aback, but was quick with an "it's OK", the typical affirmative Kenyan response.

"I started driving for Max one year and a half ago, but I have been driving since 2008. I started right out of high school, and now, I am a professional on Hell's Gate Ntl. Park, Lake Nakuru, and Mt. Elgon/Kenya. I haven't had the chance to own my own car yet since they can be something like 1.2 million Kenyan shillings, but I think I would like a Toyota Fielder…silver. I think I will continue to drive in Eldoret for a while. In fact, I actually was born and raised in Eldoret, so I love it here. I once lived in Nairobi for work, but I came back since life in Nairobi was expensive and fast-paced. I like Eldoret better since I can save up money here, and I can be close to my parents. I have two daughters who live 6 hours away from Eldoret, one is 7 and the other is 4. They call my daddy, and it is very nice. I hope that one of them will become a doctor, because that is what I wanted to be.

Yes, I've always wanted to be a doctor, but I was the only child out of 6 children to not go to college actually. When I was in high school, my father retired and would often have me work on the family farm. Because my youngest brother was in school at the time, I would skip my own classes to finish all the chores around the farm. My mother was angry that I was skipping school, so she took me away and tried to pay for my schooling herself, but eventually, she couldn't support me anymore. When we came back to my father, it was too late and he refused to pay my tuition, so after high school, I went straight to work.

I think that education is one of the biggest problems with Kenya. Many students are very bright, especially in the rural areas, but because their family can't afford to pay for secondary school (can be 50-60,000 shillings a semester), they can't get a good education. Like my story; I wanted to be a doctor but did I get the chance? If I am from a rural area, I must work very hard to pass and get good grades because it is my only opportunity. But, if I need to study and work, I can get confused, and then I could fail. Girls get pregnant early and boys become thugs, but it's not what's wrong with them, it's what's going on around them.

I think the government should help all kids get a good education and go to college, and make sure that government primary schools don't have over 50 students for every one teacher. Both the candidates running for president now are promising to make secondary school free. Some people think they will not, but I think they will.

I think that Kenya needs someone very new as our leader. Someone who is not in government now so they are not poisoned by it. Also someone who will fight tribalism, because that is destroying Kenya. You know, when people vote now, they do not vote for a good leader, they vote for their own tribe, and many people are illiterate so they don't know any better. I don't know if the tribalism problem will change in my lifetime though…maybe, though the chances are very low. I think the solution to this will have to be God. We have to pray for change."

Posted at 02:09

Post #4

Today I believe I experienced the true meaning of the AMPATH consortium. It wasn't a huge life-changing experience, and we didn't save hundreds of lives. Rather, we managed to play a single movie for the kids in the children's hospital.

It all started 3 weeks ago when John, one of our Team Leaders (and essentially our dad/RA/camp counselor) brought up using his projector to play a movie at Shoe4Africa, the children's hospital at Moi Teaching and Referral Hospital (MTRH). It was an off-handed comment that stuck with me, and when I brought it up to him again a few days later, he was very enthusiastic and suggested we do it the next day. Grant, Roshni, and I had no idea how to pull this off, so we began our series of struggles.

First, Roshni tried to get the movie we wanted, Sing, from her friend. That didn't pan out. Then we tried to figure out where in the hospital we should show the movie. Lots of varying opinions here. Then we had to figure out the projector situation. It was a clear reminder of why I didn't go into computers/engineering. But thanks to some last minute scrambling and craziness, we finally found ourselves setting up in the center of the 2nd floor of Shoe4Africa, with lots of children and parents peering around the corners of the wards at us, wondering what we were up to. After 30 minutes, dozens of child-sized plastic chairs, and lots of help from (our savior) Ernest, I was pushing the play button at last.

As the movie began, people began trickling in in a steady stream. We went from 20, to 30, to 40, to 60 and more children, mothers, fathers, and even an occasional medical student, all pausing/settling in for this movie. There was lots of laughter every time a butt was on the scene, and lots of chuckles from the moms each time any animal flirted with another. However, the largest waves of laughter by far came when the projector ran out of battery because I had forgotten to switch on the power strip. It literally continued until I got the image running again (my 5 minutes of fame?). 



Filling up the 2nd floor with our own little movie theater


I watched the families watching this movie, and it amazed me how much joy could come from something that took us one afternoon to throw together. The film was a reprieve for the kids who spend their days taking medicines and being poked and prodded, and a break for the parents as well, who must worry about their child's well-being day in and day out. For Brian, a little boy with burns all over his body, it was just a chance to play games on my phone.

The next week, we came back. This time it was an hour of classic episodes of Tom and Jerry. I set Brian up with my phone (complete with newly downloaded driving games), started the episodes, and watched the magic happen again. The families laughed at the antics of the famous cat/mouse pair, and Brian shared my phone dutifully with the kids around him, ensuring that everyone had a turn.

Then, today happened. 30 minutes before we were to head to the hospital for the movie, I realized the projector was not working. After frantically trying to fix it (aka: lots of silent praying and begging), I knew it was hopeless. However, something in me kept shouting that we couldn't let down all of those families and children, so giving up was not an option. This is when the consortium magic happened. Rachel, a biomedical engineer from Brown, along with Gus and Neha, fellow medical students from Mt Sinai, saw my struggling, and came to help. After little success, we figured we'd go to the hospital armed with a laptop screen, coloring books, and bubbles, and hope that the kids wouldn't be too disappointed. When we arrived, Brian was waiting for us on the 1st floor, and at least 30 people were on the 2nd floor, all expecting a movie. Through our brainstorming, we finally concluded that the best plan was to play the movie simultaneously on both my and Rachel's computers, while trying to sync our playing so that we could use the one speaker we had to play sound. At the end, Ernest just moved our sorry selves to the 1st floor, turned on the TV, and connected us that way.

A beautiful showing of Tangled later, I now sit, back at home in the med school hostels, feeling so grateful for the people around me. 3 universities were represented tonight, and even when things seemed impossible, I found myself surrounded by people who truly believed and cared about this cause, as small as it was. We didn't cure HIV/AIDS tonight, but we were able to bring a bit of peace and laughter to a place that is too often associated with pain and sadness. I was proud to be working alongside these people, because in our own little way, I think we brought to life a Franciscan benediction that I learned about today. Even though I am not a religious person, this struck me to my core, and it goes like this:


May God bless you with a restless discomfort about easy answers, half-truths, and superficial relationships, so that you may seek truth and love deep within your heart.

May God bless you with holy anger at injustice, oppression, and exploitation of people, so that you may tirelessly work for justice, freedom, and peace among all people.

May God bless you with the gift of tears to shed for those who suffer from pain, rejection, starvation, or the loss of all that they cherish, so that you may reach out your hand to comfort them and transform their pain into joy.

May God bless you with enough foolishness to believe that you really can make a difference in this world so that you are able, with God's grace, to do what others claim cannot be done.


And it is armed with all of our wonderful foolishness that I excitedly await next week's movie (and adventure).

Posted at 00:10

Post #3

It's been a month into my trip here in Kenya, and it's into our 3rd week at the medical student hostels. Our stay has been marked by a power outage, 3 water outages (I'm sure there's a technical phrase for this), countless cold showers, seatless and flushless (again, making up words) toilets, and a general lingering scent of certain 'facilities' throughout the floors. While Grant and I still wish each other luck each time we venture out to the bathrooms, living in the hostels has given me a much deeper appreciation for how privileged I am.

Before we moved to the student hostels, we lived at IU House. This community is a little Western bubble amongst the Kenyan society that surrounds it. Hot water, internet connection, laundry services, amazing kitchen staff, clean drinking water, and backup generators ensured that we never had to live outside our comfort zones. Lunch was served every day at 1PM, and dinner at 6:30PM. We had meals from chicken noodle soup, to fries (called 'chips' here), to grilled cheese sandwiches. We never had to do dishes (except when we wielded our vastly superior cooking skills to make pancakes or pasta on the weekends), our rooms were cleaned for us upon request, and it really was no different than living in a hotel. However, we knew this wouldn't last since we were scheduled to move into the medical student hostels for a true 'medical student experience'. 


The day we moved to the hostels, I had told myself, "if the Kenyan medical students can do this, I can too". Dunia (essentially our mom here) took me around for a tour of the building (aka: we wandered around together until we ran into something), and when she left us to settle into our new home, I could see the pity in her eyes as she drove away. That night, I gritted my teeth, threw on my crocs, and went to brave my first shower. This essentially meant I wandered around the various floors for 15 minutes and harassed poor, unsuspecting guys I ran into about whether the unmarked restrooms on each floor were for males or females. Once in what I prayed was a female restroom, I wandered around the various shower stalls looking for the single working shower head (4th floor, furthest one in by the way). I then took the shortest, coldest shower of my life while attempting to keep my eyes on the bug whose home I was apparently infringing upon in my efforts to maintain hygiene.

I know. I'm not making things sound very good. But as the weeks went by, I resolved to resist the temptations of returning to IU House for hot showers because, as I reasoned when I first got here, if the Kenyan medical students can do it, I can too. I learned to appreciate the little things, like the lack of bugs in the stall, fewer strange puddles on the floor than usual, and the feeling of warmth after stepping out of an ice cold shower. More importantly, I learned to appreciate the bathroom conversations I had with the students (more like me desperately attacking them with overly cheerful hellos), waving to our floormates when on the wards, and the kind souls who reach out to a 'muzungu' (foreigner) in need. In fact one time, a girl saw me brushing my teeth when there was no water running, and without me ever asking her, went to her room, and came back to offer me a pitcher of water.

I think that to the Kenyan medical students, I will always be a 'muzungu'. I'm sure they still wonder why I'm here, wandering their halls, but I hope that with time, they will grow accustomed to my presence. After all, in the grand scheme of things, we are all in this journey together. The students here deal with all the challenges we face as students in the States, in addition to nurses'/doctors' strikes, severe lack in resources, patient cases beyond belief, and (the horror!) cold showers.

Yet they prevail; yet they return to the wards each day to care, learn, and heal; yet they do all they can to help their community. I have so much respect for them and so much to learn from them, so I start small by living with them. And at the end of the day, even for Westerner like me, you'd be surprised how much you can grow to appreciate a tiny stream of cold water. 

Posted at 04:00


Latest comments