Bernard Coleman’s Kenya Journal.

September 20-October 2, 2008

Journey: AVL-ATL-AMS-NBO uneventful

Met ATL contingent at airport

Arrived hotel 9:00 pm  Sunday.

Monday 8:00 orientation meeting

9:30 am bus to Mukuru, a slum on the south side of town which houses about 500,000 people.  Many migrate here from other east African countries before they move on but there is a large stable population of the most desperately poor.  Most are malnourished and poorly clothed.  Many of the men walk out of the slum to the main road to go to work.  Others set up stalls along the road to sell all sorts of merchandise.  There is no running water or sewerage and women collect water in 20 litre plastic cans which they carry on their backs back to their homes.

1 hour in rush hour traffic in central Nairobi:  30 min over unpaved road through slum area…bone shaking, teeth rattling on bus.  When I asked the driver how often he changed the shock absorbers, he said, “What are shock absorbers?”

The buses used to transport us are the oldest in the city fleet, just before they are retired, but the drivers are superb.

Two other camps at Mathare (Danish dental team) and Korogocho (Brazilian dental team)

Camp on campus owned by archdiocese.  Four buildings, medical, dental, optical, pharmacy.  HIV/AIDS testing and counseling station offsite because contraception part of program.

Medical building – dormitory with showers and toilets.  Local volunteers string lines and sheets from ceiling to provide partitions and privacy.  One of our nurse practitioners who has been on 11 mission trips described our site as the best she has worked in.  Usually camps are set up in schools or churches, often with dirt floors.

Besides Rotary International and RFFA, HOPE, HEART, AfricaShares (Micato Safaris), Kenyan MDs and Kenyan medical students involved.

Of 73 Rotarians only 4 are MDs: self and Margot, Pam Colman, Cincinnati, and Yolanta Melamed from Georgia and 2 NPs  Mission leader from Atlanta, Rotarian Sally Platt, RN

Monday afternoon, a party of local schoolchildren run through the system to make sure things are working properly: screening, deworming, examination and treatment. 

Finish work at 4 pm.  Travel back through rush hour traffic…2 hours in bus.  Arrive at hotel exhausted.  Almost fall asleep over dinner.  Retire to bed early.

Tuesday:  Repeat of 90 minute commute.  Could use massage.

Medical team sees and treat more than 260 children.  Minimal box lunch in 20 minute break.  Assisted by fourth and fifth year medical students who translate from local languages and help with diagnosis and treatment.  My clinical skills are quite rusty…they haven’t been used in more than 35 years.  For some reason, or maybe not, sex is not indicated on patient records.  Saw a three-year old boy in a girl’s dress—the youngest cross-dresser ever.  Probably couldn’t afford anything else.

Arrive back at hotel even more exhausted than Monday: early dinner and early bed.  Intend to leave hotel tomorrow at 7 am to beat traffic.

Wednesday: early morning commute reduced to just over one hour.  The ride doesn’t get any more comfortable.  Today we saw more than 280 patients…with one less MD.  Saw some really sick infants and toddlers and a few school age kids.  Most of the others have worms and upper respiratory infections.  Quite a lot of malnutrition.  Assisted by students and Kenyan MDs.  All are very helpful.  There is a lot of consultation among the team.

Non-Rotarian volunteers include Rebecca, a nurse fresh out of nursing school in Australia who is spending a year in Kenya and Marie-Claire Coleman, an Irish paramedic who is spending a year in Nairobi before moving to South Africa.  Rebecca left today to spend Rosh Hashanah with her brother in Israel.

Thursday:  Another day, another bus ride.  The first of our two buses wouldn’t start, so Margot and I volunteered to ride in the second.  Bad choice…the only seats were over the rear axle.  The only good part is that we beat the traffic and arrived on site in 50 minutes.  The broken down bus was replaced and the riders arrived an hour after us.  A busy day: more than 300 customers today.  Once again we were assisted by medical students who acted as interpreters.  We finished early because we had to return to the hotel to smarten up before going to a reception at the US Embassy.  Ride home took 50 minutes.  Becoming obsessed about effects on my neck and spine.

“The Deputy Chief of Mission of the Embassy of the United States of America, Pamela J. Slutz, requests the pleasure of the company of Dr Bernard Coleman at a celebration of the Rotarians for Fighting AIDS—Kenya Medical Mission - 2008 on Thursday, September 25, 2008, 5:30 pm to 7:00 pm”  About 120 people attended the reception with unlimited beer, wine and soft drinks and tons of delicious finger food, on the patio and lawn of Tate House, the residence of the DCM.  Protocol requires that the DCM addresses you first and you respond calling her Mrs. Slutz.  The DCM approached our small group and said, “I’m Pamela.”  What an icebreaker!  What a delightful person!  What a party!  And this all on our 43rd wedding anniversary.  Who else do you know who had an anniversary party for 120 people at the US taxpayers’ expense? Just before it was time to leave, the DG’s wife invited us all over to her pad for dinner!  If anything the DG’s house was even more palatial than the DCM’s.  We were served an authentic Indian dinner and more drinks.  The bus back to the hotel was a little rowdy…and so to bed.

Friday:  Made the commute in 50 minutes.  Saw over 320 patients today…from 3½ weeks to 19 years…from chicken pox to child abuse.  Our translators were Kenyan medical students and a couple of Rotaractors, studying to be actuaries and mechanical engineers. 

Bus driver took us home by different route.  Asphalt surface somewhat uneven (gross understatement).  I suggested it was a traffic calming device but one of our volunteers called it a “Nairobi massage!”  Drive home took only 90 minutes.

Hotel owner hosted party for Rotary volunteers.  Lots to drink, fabulous food and great fellowship.  Bonding among our group is phenomenal.  We have shared our fun with people from Australia, Tanzania, Kenya, Brazil, Denmark, the UK, Japan and the US.

Saturday:  Another working day.  Set off from the hotel at 7:15 am and arrived at the clinic at 8:00 am.  Very little traffic, but it still took 20 minutes to drive the last 2½ miles through the Mukuru slum to get to the clinic.  After an hour to set up we started to see patients.  By 4:00 pm we had seen more than 370 with even fewer doctors than yesterday.  Our Kenyan doctors had the day off.  We spent more time consulting with each other on confusing and difficult clinical problems.  Almost every child had an upper respiratory infection in addition to other problems. 

Such a level of activity in these conditions is unsustainable so it is just as well we have only two more working days.  Today’s translators were 2nd year medical students, mostly beautiful young ladies who had never examined patients so we had to take time to show them interesting physical signs.  Our drive back to the hotel was in an even more decrepit vehicle than yesterday’s with windows missing and seat stuffing falling out.  This did not stop several members of the group from falling asleep on the relatively short 50 minute drive back to the hotel.

A quick shower and change of clothes before getting back on the bus for half an hour to attend the Rotary District 9200 Governor’s reception for the mission team at the Jacaranda Hotel.  Beautiful poolside covered patio and tables looking as though they were ready for a wedding.  Then the speeches!  First the DG welcomes everyone, then Buck Buckingham representing PEPFAR from the US Embassy, then the US Ambassador, then the president of the RC of Nairobi North, then the DG again, then Marion Bunch, the CEO of RFFA, then Sally Platt, the organizer of the US contingent, then we had a rambling speech from a dentist from Japan whose English was less than perfect and an interminable song in Portuguese from a Brazilian dentist…by which time we were all dying of hunger.  We finally got to the buffet at about 10 pm!  At about 11 pm the floor was cleared for dancing!!  After getting up at 5:30 am to go to work, we were not exactly in the mood for dancing.  We finally got to bed about 11:30 pm.

In addition to the US Ambassador, diplomats included the Deputy High Commissioner from India and a high ranking official from the South African High Commission.

Sunday morning:  What a relief to be able to relax, take a leisurely shower and even more leisurely breakfast.  Caught up with email and sat in the shade by the pool.  Other members of our party went shopping or to church or to the Karen Blixen home.

At noon we got on the bus once again to go to a cook out, put on by the Rotary Club of Nairobi.  To our immense relief, the speeches lasted less than five minutes.  We had a fabulous meal cooked by the men of the club.  The president is an ob-gyn who had to leave briefly to deliver a baby.  We met several club members who are actively engaged in social programs, education, HIV/AIDS trials, and many more.  After the meal, we had a demonstration of African dancing and our team was invited to participate.  We took the early bus home and fought off sleep until 8 pm and went to bed.

Monday:  Week 2, day 1:  We get back into our routine and spend an hour on the bus.  We make sure we are nowhere near the rear axle.  Today we treated 340+ patients and by the end of the day we realized we are getting too old to do this.  We saw some interesting cases among the routine coughs and colds.  More child abuse and a giant nevus and some odd rashes.  The bus ride home does not get any shorter…1 hour and 20minutes through the rush hour traffic.  Back at the hotel we had an early and fun dinner with our physician and nurse colleagues and retired to our room at 8 pm, too tired to socialize at the bar.

Tuesday:  Our final day at the clinic.  Got there in record time.  Saw more than 280 patients today for a grand total of 3,889 in eight days.  And it feels like it.  We finished at 2 pm and had to clear away all our “stuff” to let the building revert to other uses.  Our local volunteers have been magnificent: from cleaning the restrooms to escorting patients to translating and a whole lot more.  We could not have managed without them.  Today I had a fourth year medical student from Leipzig, Germany to shadow me.  He is in Kenya for two months on a student exchange program.  By 3:30 pm were through and on the bus, expecting a record time to get home ahead of the traffic.  Wrong!  It is the festival of Eid and everyone is on the road trying to get home early.  So 90 minutes later we arrive back from the camp for the last time.  What a relief!  A quick shower and an early dinner to get to bed early for 6 am start on a mini-safari.

Wednesday:  Up at 5:15 am to get on safari bus for three hour drive around Nairobi National Park.  This is a large area on the edge of town with access for wild animals to migrate from other wild life areas.  The park abuts a large Masai herding area.  We saw lots of animals but no big cats.  Then on to the Giraffe Center to feed giraffes by hand and by mouth.  A short visit to the Karen Blixen Home (Out of Africa) and the Carnivore restaurant for long, leisurely lunch before returning to the hotel.  Off my food so skipped dinner and had early night.

Thursday:  Had a lie in until 7:30 and then a leisurely breakfast followed by a walk into downtown Nairobi.  Visited the US Embassy Memorial Garden commemorating the terrorist bombing of August 7, 1998.  Treated ourselves to lunch at the Nairobi Hilton…what a change from our digs for the past 10 days!  Spent relaxing afternoon packing bags for flight home.  Our bus to the airport was delayed by a torrential downpour, the first rain we had seen and by the presidential convoy on its way to the State House.  After some anxiety about whether we would have enough time at the airport, the contrast from last year could not have been more different.  The lines were short and there were no problems with check-in.  Our plane was full but we gratefully found our seats and took off for the first leg of our flight home.  The rest of the journey was loooong but uneventful and our dear neighbors were at the airport to drive us home.  And so to bed.

This is the most important, worthwhile and valuable activity I have undertaken in my 37 years of Rotary.  Although we were only able to scratch the surface of the needs of these desperately poor people, we have made a start and the local organizations will continue to provide some services.  The architect who built the facility we used has promised to build a permanent clinic on the site and the Catholic diocese has promised to help staff it.

 Other members of the team kept blogs which seem to describe an entirely different experience.  I have consolidated their entries to make it easier to follow:

I'm joining a mission trip to Kenya September 20-October 2, 2008. Here you'll find what I'm up to prior to and during the trip!

Alexandra Ricca  (Graduate student)

Tuesday, September 23, 2008

Greetings from Kenya!! :)

Here is my first update, a lot has happened since I got here, but I will try to sum up the highlights and keep it somewhat short :) (somewhat!)

I am learning SO much here in Kenya. I got in Sunday night and we started off with a meeting Monday morning with the other 72 volunteers at the hotel in Nairobi, then got to work. We are divided into 3 groups, each at a different slum community. I am in Mathare with a team of dentists from Denmark. They are a wonderful team! I have been helping a little with the dentists, getting children in from the other room, making sure they have paperwork, and keeping them organized. We are at a center called Community Transformers (CT). It is a group of young people like myself who first started out helping a family. It kept leading to different projects, and now they have several offices around the slums. They are absolutely incredible. I read about these programs, but wonder how they really work, and what they look like. These kids are changing their community. They've had computers donated to them, t-shirts, banners, posters, stickers, etc. For the rest of the week, when they are free, I will be helping some of them learn Excel. They do house visits, conduct clinics like ours, and the coolest... work with the VCT (Voluntary Counseling and Testing) team. And this team is equally impressive. I walked to the VCT clinic today with a few of the Kenyans quite a bit deeper into Mathare. (The CT office is right on the outskirt, so although it is bad, it is nothing compared to the interior of the slums...). The walk was difficult. I'm finding my days here are mentally, physically and emotionally exhausting. I have shed a few tears, but try to keep it together for everyone around me. Everyone I have met has such a positive outlook, and it is infectious. The VCT clinic is part of a school that the team is using for space. They move every few days to a different section of the slums. Inside the building, they set up tents and put two chairs inside for privacy. Each person that tests and counsels is trained and certified by the health ministry. To drum up excitement, another group goes out front and starts singing and does a skit with reference to why it is so important to get tested. A lot of people gather around and they get some clients this way. (I took a video, so will find a way to post it when I get back!) They also walk through the community with a banner, singing and yelling and convincing people to get tested. Once they are tested, if their status is HIV positive, the counselor gets them in touch with a doctor, and they get started on ARV therapy immediately, for free, paid by the government. How wonderful is that?? I went to a Rotary meeting tonight and learned a little more about the stigma around HIV and AIDS. Some companies would fire people who were positive, while health insurance companies decrease coverage once you are found to be positive. In turn, that makes people not want to get tested, and it's of course a vicious cycle. Vickie Winkler, the founder of HEART (an absolutely wonderful woman, I am taking quite a liking to her and really look up to her) told me a story about her bringing a group of VCT members and community leaders for testing. She asked all the leaders to get tested first, they hesitated, but once they did, people were waiting in line to get tested! She said they did tests on 400 people in 2 days by doing that.

Other things that have happened- Kenyan children LOVE the camera :) They especially love to look at themselves once a digital picture is taken. They all yell "How are you? How are you? How are you?" over and over again until they get our attention. Or they come up to you, hug you, grab your hand, shake your hand, tug on your shirt... they are amazing little beings. And tough cookies! Some of the dental patients have been having some major work done, and they don't make a peep. I've also had many chances to sit down and talk to some of the Community Transformers. They are so bright. They have such high goals for themselves and are so inquisitive and interested in everything I have to say. They love to ask me questions and love to tell me about their lives. I'm learning so much from them. Nick, one of the CT/VCT team members told me about his uncle who is HIV positive and in turn, his 2 children are. I really was able to get such a great perspective, and learn that is what drives Nick to do well in his community. Another young man, Paul (who I think has a crush on me!) is a nurse. He wants to go to the US and become a citizen. Eric is another CT member who is a little shy, but he is so polite and helps me find things and translate if needed. I spoke to an older woman today, she is making me a necklace and bracelet with the HIV/AIDS ribbon in beads! She does beautiful work. Charles and Jesse are other great guys, Jesse works at HEART twice a week, then is at CT and VCT the other days. I talked to two other Kenyans today about our health insurance, Medicaid, Medicare, the cost of school, HIV/AIDS in the US. They were very interested, they learned a lot from me, and I from them.

Well, it's getting late for me, and I have another full day tomorrow. I'll try to keep you updated, but I thought you would be really interested in hearing a little bit about what I've been doing and what I've learned so far. It's so encouraging and I have just been so excited, almost to tears, for what these young men and women are doing! It's been a great experience so far!

Wednesday, September 24, 2008

Maria and Timothy

Maria and Timothy are my two new favorite kids (sorry Lillie and Arizona!). They are always hanging around Community Transformers. I think they live in the same little area. I have a great picture with both of them and can't wait to put it up here when I get home. They are so polite and love to hold my hand and of course ask "How are you?!" (I think it might be the only thing they can say in English, besides "I'm fine!")

Today was another jam-packed day, we saw 46 kids and pulled 61 teeth. We had a few screamers, but most of the kids were very good and very strong. Although our team is not as big as it was supposed to be (in the beginning, everyone was to be together- medical, dental, optometry, nurses, etc. and we were to move to a different slum every few days. Instead, we are all split up due to politics in the grants). The weather was really hot... but we are very lucky because we are inside for the whole day and it stays reasonably cool and comfortable! Plus, not many bugs. A few flies make their way in, but that is about it. When Jackson picked us up this afternoon, there was a HUGE traffic jam, people and cars were everywhere, I managed to get a decent video of it all!After the camp today, we stopped for some money, lollipops for the kids, then went and got some posters, chalk, pencils, etc. for a school nearby our camp.

I've made great friends so far (besides Maria and Timothy!) with Paul, Washington, Eric, Nick, Joseph and Charles. Again, they are such an incredible bunch! We've taken a few pictures together, so of course will post those as soon as possible.

I bought a bracelet and necklace from "The Mother" (she is an older woman with AIDS that helps support the young adults at Community Transformers)

Well, I'm going to get a shower, do some journaling and head to bed. It's only 7:00, but I'm exhausted. We have a busy day tomorrow and a reception put on by the U.S. Embassy at an expatriate's house with the entire group that is here in the evening (in all the slums, not just ours). It should be a great event!

Friday, September 26, 2008

Inspiring...

Today is Friday and we finished a bit early. The last group of children were unable to make it from school to the dental clinic. A great chance to get a post up!

Yesterday was a long, but fun day. We of course were at the dental clinic all day, but took a break around lunch to go to a HEART WEEP center. I don't even know where to begin. These women started working at WEEP when they were very sick, hungry, and unable to care for their children and any other children in their family. All the women that work at WEEP have AIDS. But now they have learned a trade (they make school uniforms for a program HEART puts on for schools upcountry and sweaters, soap and shirts) and are so strong and confident. They were so happy to see us and told us a little bit about them. How many children they have, that Vickie has saved them, and that they love working at WEEP. There are no words for them either. They are amazing women doing great things for themselves, their families, and their community.

Our group left by 3 and stopped at Windsor Golf Hotel and Country Club (I know, what a contrast...). Yes, there are country clubs in Nairobi, and they will give American country clubs a run for their money! You can go from the slums in the morning, to an absolutely beautiful club or home in the evening. And that's just what we did last night. The Danish team came along with us in the HEART Land Cruiser so they could shower at the Lodge with us instead of going all the way back to the hotel in downtown Nairobi. It worked out nicely and we were on our way to the U.S. Deputy Ambassador's residence. Absolutely beautiful home, like out of a movie. There were several white tents set up, tall tables with flowers and candles, and open bar (including wine and Tusker, a favorite African beer). Nick (the founder of Community Transformers, and my new buddy) and Pastor Lou (from California, also staying at the HEART Lodge) came with us. I was very excited Nick came because I really wanted him to meet as many people as possible. He needs the exposure. I believe in his organization and what it is doing for the community of Mathare. In Mathare, they say as many as one in three could have HIV. Nick thinks there are approximately 2 million people living in Mathare. Nick was able to talk to me a little about where he has come from and where he has been and wants to go... he was raised in Mathare and his parents died when he was very young. Many of his family members have AIDS and some have died from AIDS-related diseases. He understands what life is like there and what the struggles are, and he wants to change it. He opened a rescue center for children, started Community Transformers, is part of the VCT team, does home-based care, makes sure children go to school and take medication if they need to. He also takes people to the hospital if they are unable. Children are very near to his heart, and he has the dream of a generation free of HIV and AIDS. Every day when he goes out there to do VCT, he hopes he will get more and more people to come. The more people that come, the more he and the others can help. It's so difficult to put this all on paper... but when Nick talks, you know he truly loves his people and that he wants to do everything he can to help them. I really want to try and do something for him and his organization. I told him I can try to get an article he writes in a journal for exposure, or send over some books or supplies, even help get him to a conference in the United States. He's never been, but when I told him he can stay with me, he was so happy and so excited.

After the deputy ambassador's house, we went to the district governor's house. Another mini mansion. We had dinner there and were recognized again for our efforts. Geeta Manek is head of the Rotary group 9200 in Nairobi, and it was her home. She is a wonderful woman, and very sincere and hardworking.

This morning I sat with Nick in the CT office (with Maria on my lap) and he told me a little more about what he is feeling and how he was so happy I introduced him to some people last night. He is so inspiring (I think I keep saying this over and over again, but there are just no words to express how proud I am of this young man. He is only 26 years old and changing a community with the help of a few friends. These guys could very easily be doing something else and have nothing to do with the good of the community. Colins, for example, is only 23. I didn't have a job at 23. I was living with my parents, looking for a job, working at the golf course... hardly a feat compared to them...) He showed me the book where they keep track of everyone they test, so far this week, they have tested about 150. Nick said he was in Mathare around 6:00 this morning trying to find a place for VCT to be today. He has to walk around and look for empty rooms or spaces, and ask the people around if he can use it. Incredible. He is so proud of what he does, and he continues to fight for healthy Kenyans. David, another guy from California sat with him and Leah for a while showing them some things on Excel. They just received computers from HEART and are just learning how to use them. I am going to work with them a little more while I am here to make sure they will be able to keep their finances straight for the remainder of the year with their grant. We hope they will earn another grant for next year.

Well, I wish I could write more, but sometimes there are no words for what these all of these people are doing. I am so happy to have met them. We are planning on keeping in touch, and I hope I can come back again soon to see how they are doing.

Tonight we are going to the hotel for another reception. Nick, Colins, Paul, Eric and Stephen are all invited. I'm REALLY excited for it :) I like to show them off. It seems the other teams are not having the same interaction we are, and I am very grateful for that! It's amazing how much you learn about everything Kenya when having a conversation with someone who is from here... I can't wait to see what the next few days will bring.

See you!
Alexandra

Sunday, September 28, 2008

Mutatus, a party and toothbrushes

Jambo!!

It wouldn't be right if I didn't make at least one comment on Nairobi traffic. The notorius Mutatus (Moo-tah-toos) are all over the place. Someone told me there are over 40,000 in Nairobi. They are these mini buses that are pimped out, and I'm not joking. They have systems and are always blaring music (Ruby-style, to all of you who know what I'm talking about!), have decals all over them with pictures of Ciara, Kayne West, Snoop Dogg, Bob Marley, etc. They also have sayings on the windshields- for example "Lo Ryder", "Smooth", "Luscious." It's hilarious. They also have neons inside, so at night, they glow... They are always packed with people, with children on people's laps, all schmooshed in! Add them to crazy traffic, road lines missing from most streets, no crosswalks, people walking and riding bikes everywhere... and you get a recipe for disaster! I don't want to forget to mention the people who CUT THROUGH the round-a-bouts!! Or the Mutatus that go the wrong way on a one way. There are no red lights. There are hardly any cops.

I think my last post was right before the reception at the Kenya Comfort Hotel Suites with all of the other volunteers at the other sites and our lovely Kenyan volunteers. I was so excited to spend the night with Stephen (of Hope Worldwide), Elizabeth (a nurse), Paul, Nick and Collins. I sat between all of them and we had a great time. It was definitely the best night so far. Nick and Collins are hilarious- they act like brothers. I want to take all of them home with me in my suitcase :) I really enjoy their company. They have such positive outlooks and their caring attitudes are addicting! They are amazing young adults...

I met Carl Good at the hotel Friday night and talked him in to joining us in Mathare so he could talk to Nick about his programs and see their VCT site. I was happy for Nick, because I think Carl has a pretty big influence on HIV testing, and I want Nick to get as much exposure as possible for his organization. Carl came on Saturday and said he was really glad to see the VCT and what they are doing on the ground. I can't wait to put my video up on YouTube of the skits they do to catch the attention of the passer-bys.

Yesterday (Saturday) was tough waking up. Luckily, the doctors finished up with the clinic really early. Fay and I were just outside Mathare helping some dental students distribute over 1,000 toothbrushes and pens to some school children for most of the day. The students also gave demonstrations on brushing teeth, some oral hygeine and William (one of the HEART drivers) gave a demonstration on hand washing. It was a great experience and wonderful to see how all the kids reacted. They were all so excited to get a toothbrush and a pen. Hope Worldwide donated milk, bread and other refreshments for the children and helped us organize all the kiddies.

When we got back to CT from the school yard, William helped us load everything into the Land Cruiser and the Danish team came with us so they could shower at HEART before the Gala that was put on by the District Governor. We were almost to Lord Errols (an amazing restaurant where we wanted to stop for a drink before showering) and William rear-ended someone. The car was a small Rav-4, and the HEART truck is massive with a big bar on the front. No damage was done to our truck, but the Rav-4's rear windshield shattered and made a pretty nasty dent in the back. The guy in the Rav-4 works for the UN, so he was able to get a hold of the cops quickly. Apparently, it could take up to 3 hours for a cop to show up. It was a mess. We caused quite the traffic jam! One of the cops even bribed William- that if he didn't give up 1000 shillings, he would take him to jail overnight!!! Crazy! We finally made it to Lord Errols, had a drink on the terrace (another amazing place, in contrast to the slums) then went back to HEART to get ready. We went to a hotel in downtown Nairobi for the Gala. It was very nice. I sat with a group from Pennsylvania- Peter, Andy and Amrita. They were all really nice, and it was a good change from the team (don't get me wrong, I love the team, but Andy and Amrita are my age!). The US Ambassador was there, and a few other ambassadors. He had a great speech and it really opened my eyes to the great relationship the US has with Kenya. It's very encouraging! At the beginning of December, the White House is unveiling a new program that is suppose to have a HUGE hand in the fight against HIV and AIDS. I am really looking forward to learning more about the new program. It's amazing what President Bush has done for Kenya and the fight against disease here. The head of PEPFAR in Kenya was also in attendance last night, Buck Buckingham. I was hoping to have a moment with him to chat, but he is quite the busy man. We were all anxious to get home and into bed, so immediately after dinner, we all headed back to the HEART compound. I was starting to feel like I was coming down with something, so I took a Tylenol and jumped in to bed! I slept so good last night :)

Today we had the day off. It was really relaxing and a nice change of pace to stay out of the slums for the day. Although... we did drive by Kibera slums, but we were quite far away. Kibera slums are one of the largest in the world, I think second next to a community outside of Buenos Aires (?). Me, Vickie, Fay and William went into town to pick up the Danes and we were off to the Giraffe Center!! It was so fun. We were allowed to touch the giraffes and feed them, I've got some great pictures. I could have spent all day there. Then, we stopped at Karen Blixen's house (the author of Out of Africa), did a little shopping, then went to the Rotary Club of Nairobi for a cookout. I met up with Lizzy there and we had some great food. We didn't stay for very long. Vickie wanted to get back, and I am really glad we did come back early.

I needed this day to reflect and recover a bit. We still have 2 more days in Mathare, and I want to make the best of them. Nick is supposed to take me to his rescue center for children, and I want to go back to VCT. Wednesday is our one-day safari, and Thursday I leave for home! I can't believe how quickly my time here is going. I'm not quite ready to go home. I've begun to make such great relationships with people here, then I have to leave :( Nick wants me to spend the day at Community Transformers with him on Thursday since my flight isn't until 9:30pm or so. I'm not sure how I'll get out there, but I'd like to spend the day with the guys again. I also wanted to help them a little more with Excel spreadsheets. David has helped them quite a bit, but I want to make sure they have it down before we leave. I also want to sit down with Nick and see if there is anything I can get him or send him from home. He really is starting from scratch, and although they have some great resources and a grant, there is so much more they need to support themselves and their community. Any suggestions?

Please keep reading, and leave me comments or send me emails!! I love reading them and it really means a lot to know you are thinking of me! :) Also, don't forget to check out www.mnpblog.com for pictures from Michael Norwood. He took some great shots while he was here and many of them are from our clinic and the VCT clinic in Mathare that I've been to.

Asante sana! (Thank you!)
Alexandra

Tuesday, September 30, 2008

It's hard to say goodbye...

A crazy few days it has been! Yesterday was business as usual at the clinic. One of the women that live near our clinic invited us into her home. This was my first time going into a slum home, and I was surprised at how big it really was. Granted, this is a better slum house than most in Mathare, because she had concrete floor as opposed to dirt. She had beautiful black and white photos all over the walls of her family. She had 14 children and one husband (although, her husband had 2 wives). She doesn't speak English, but her daughter translated for us, and told us a story about her husband and some of her children that passed away. She offered us Cokes again, and although we feel awful taking them, it is disrespectful not to. We always give them away to one of our volunteers because we know we don't need them.

We finished up the clinic early on Monday, so headed out to run a few errands. After coming back to the HEART compound, we showered, got ready then were out again for a Nairobi Rotary Club meeting. I'm not even in Rotary and am starting to consider myself one of them! I've been to a few meetings and have met so many Rotary International members! I'm definitely going to look into it when I get home. Anyways, we met Dr. Mir at his club (Dr. Mir has a clinic in Mathare and has been signing all of our registration papers at the clinic). It took us a while to get there with a combination of traffic and getting a little lost. But, we finally made it and did a meet-and-greet with the other members. The president's wife, Cheryl, has started a project on books for younger children about HIV and AIDS. I need to give her a call because she said she would try and get the books to me before I leave. I didn't have a chance today unfortunately, but will try tomorrow or Thursday.

It was tough pulling up in Mathare this morning, knowing it was my last day. I've gotten into a routine, and every day I look more and more forward to seeing the kids and spending time with everyone at Community Transformers. It was a normal day, organizing the kids, getting some good photos, talking to my Kenyan boyfriends :).... the usual! I talked to Stephen for a while today, he works for Hope Worldwide. I've learned a lot from him as well about what he does for the children in his community and his love for them. It's amazing how these people work SO hard for what makes them HAPPY, not what makes them money, and they are really making a difference. Again, I'll say it, they are such an inspiration! They have touched my heart and changed my life. This has definitely been an amazing experience and worth every effort. I had expectations, but they have long been passed!

Before lunch, Nick took me to his rescue center. He has rescued 32 children. One of the little ones is HIV positive. Another, he found near a sewage ditch (and when I put up my pictures, you will see what these ditches look like....). He has 2 rooms I saw that are already set up. One for girls, one for boys. Each room has several bunk beds, but the rooms are VERY small. A few women work there and help watch the kids and feed them. Nick just got another room that he wants to get a TV in and make it a game room for the kids to have a place to play. He told me that many nights he stays there with them until they fall asleep... he just loves those kids. I can't wait to show you my pictures of the center and with some of the children. They weren't all there, because most were still in school! But, I did get to carry around one of the babies. Cutest in the world :) I told Nick he's awesome, and all he said to me was "No, you are awesome..." He really deserves so much credit. I can go home to my bed, my car, good food, a good job, a healthy and loving family, and he will still be at CT working hard for his community... and it really doesn't seem fair.

We cleaned up the clinic this afternoon, packed everything in boxes, and gathered around for a group photo. Nick spoke on behalf of all the Kenyan volunteers and thanked us. I couldn't even look at him in the eye. It was really hard saying goodbye. I gave hugs to all of my closest friends there, Paul, Washington, Eric, Elizabeth, Leah, Charles, Collins and Stephen. I couldn't give Nick a hug, and he even said he didn't want to say anything. He had to come by HEART tonight, but we weren't back yet. I am hoping to get a hold of him on Thursday, and I'm sure he will come out here to say goodbye. We shed some tears, and just held our breath as we walked out of the clinic. Paul and Washington were sitting outside, so I gave them one last "hit the rock" and swallowed hard to run up to the truck. Paul and Elizabeth ended up coming to the truck and waved at us goodbye. I just let my head fall onto the window and kept crying as we drove passed the "hotels," food stands, garbage, fires, children walking in the streets alone, older women carrying very heavy packages on their heads and men trying to bring food home to their families...

These guys and girls are absolutely amazing... and I really can't put my feelings in to words, because there are no words for them. You see pictures, and read stories, but you can never know what it feels like until you have experienced it. The sights, sounds, smells and emotions that come over you are indescribable. I have learned SO MUCH on this trip, and hope to keep my relationships with the Kenyans strong so I can come back and work with them again. I can't wait to start school to continue pushing me forward into helping people in countries like Kenya.

That's all I have for now, we have to be up really early for our treat... the one day safari to Nairobi National Park! I'm looking forward to eating at Carnivore... which is one of the top 10 restaurants in the world! (Or so I've heard). I'll be busy Thursday packing, hopefully seeing Nick one last time, and I'm keeping my fingers crossed I can grab lunch with Mary (I met Mary through my internship in Paris 2 years ago, she is a board member for the International Union for Health Promotion and Education and lives in Nairobi!) Then, it's off to the airport for my flight Thursday night! I'll be back in the States Friday afternoon, and plan to make another post or two on here with a link to my pictures and a big thank you to everyone who has been reading and who helped make this trip possible for me!

Good night for now and asante sana!
Alexandra

CARL GOOD  (Clinical scientist)

  Monday, September 22, 2008

We are in Kenya and treating patients

There are 70 of us now treating children in the Mukuru slum in Nairobi Kenya. Email access has been difficult but I have taken may pictures and had many fantastic experiences that will be posted later. The gourp is the largest such group in Rotary history and is composed of medical and non-medical personnel. The conditions in the slum are very bad but the people are wonderful.

Wish me the best.

CarlRotary Medical Mission kenya 23sep08

23sep2008

The bus left the hotel at 7:00 so George was to be there for me at 6:30 but didn’t arrive until ~7:00. Rineta drove me to the place where the cab drops him off in the morning so he wouldn’t have to walk the rest of the way to the house and then walked back by herself. George drove at breakneck speed toward the hotel. The only advantage was that I was still partially asleep and avoided conscious appreciation of the terror of the trip. As we were approaching the hotel we saw the bus coming toward us. I hopped out in traffic with George running interference with the car and was about to hop on the wrong bus. We have three sites and this one was going to another slum. Fortunately it was quickly followed by the bus heading for the Mukuru slum in which we were working.
As it wasn’t working out for my helping with the AIDS testing, today I helped register people with the help of an interpreter. Mostly this was David, a hospital lab technologist. Most of the patients were small children who were sometimes accompanied by a mother or teacher or friend. Some came by themselves. Often the mother and child has different names. Sometimes a mother would have two children and they all would have different last names. In some cases with certain tribes the mother keeps her maiden name and the child takes the father s last name.
We worked in a small gazebo that was mostly open. After interviewing the child and mother we would designate them for one of the three specialties; optical, dental or medical. Even if the child had more than one complaint they would only get one treatment to maximize the number of children who could be seen. Of course treatment was for the most important of the complaints. They would then go to another table to get a colored and numbered arm band and a de-worming pill if they handing had one recently and were over two years of age.
After their treatment the children and mothers would go to the pharmacy to get their medicines.
It is Spring in Nairobi and the weather very pleasant. In general, although being close to the equator, Nairobi has mild weather all year never getting to hot or too cold. My host’s home while being very nice has no heating or air-conditioning.
After arriving at the hotel George came to deliver some medicines and solutions for the next day and take me home. Darsi was on a business trip and I had a very nice dinner of pork and mushrooms in gravy with Rineta and her sister Bridget.

 

Wednesday, September 24, 2008

Rotary Medial Mission Kenya 24sep08Sep 24, 2008

Today we were to leave at 7:00 which meant that I had to get up at 5:30 to meet Darsi’’s driver George at 6:00 to make it to the hotel in time to make the bus to the Mukuru slum and the Catholic compound which is our base. The all went well. All the roads in the slum are incredibly bumpy I found by trial and error that one wants to sit in the front of the bus to avoid the increased bumpiness in the rear due to some form of leaver action.
More local Rotarians and Rotoracters seemed to be present today to ease the burden. Our group handled over 650 children today between the optical, dental and general medical groups. There is triage at the gate to give priority to the neediest cases. Our registration group handled mainly mothers with children and a few that came on their own. A number of school children came in groups and they were handled by local doctors and where necessary funneled into our functions. All the children who had not been recently de-wormed were given a worming pill.
In the registration process we are aided by local Swahili speakers many of whom are college Rotarians called Rotoractors. As time goes by I am getting to be able to utter a few Swahili phrases but the children are shy and difficult to understand.
Once the children have been triaged and registered with numbered armband they go and stand in front of one of three buildings that house the respective optical, dental and medical groups. Because of the large number of general medical patients a tent was erected to shade them during their wait.
The dental group has no chairs and other dental office stuff so each dentist wears a headlight and pulls teeth with their patients on a table. There is no filling as there is no equipment.
Our registration process is the first to stop as it takes time for the patients to work through the other groups. Next to the Catholic compound is a Catholic sponsored trade school. One of our interpreters, David who is a clinical laboratorian, took us over for a tour. The students are mainly high school age and get training in sewing and clothes making, hairdressing, wood working, metal crafts, electrical, knitting and math. The facilities as one might expect are minimal but functional. In the slum there are many small shops of people earning a living plying these trades. Also, there is a large industrial area near the slum which can employ the graduated students. The hairdressing course is six months with the others being one year. In the courses they make clothes for school children as well as things to sell. All the school children are in uniforms of some type.
After helping close up shop we took the bus ride back through the slum to the hotel. My host’s driver picked me up after delivering some medical supplies for the group. We stopped at a mall to get a few things like more had sanitizer. This mall would rival any I have seen in the U.S.. It was such a contrast going from the slum to this fancy mall. I have been comparing Dhaka in Bangladesh to Nairobi in Kenya. Nairobi is definitely a more advanced city but the slums are very similar.  

SALLY PLATT  (RN, Team leader)

 Friday, September 19, 2008

Countdown to Nairobi

After 7 long months of planning and preparation, much of it done long-distance through hundreds of e-mails and many dozens of phone conferences, the Kenya Medical Mission is about to begin.

Through the generosity of the Rotary Clubs of Marietta Metro, Smyrna and Dunwoody, GA; York East and North Lebanon, PA; Nairobi North; Districts 6900 and 7390 and a grant from The Rotary Foundation, the mission team will serve children in the slums of Nairobi. In the early planning stages, I don't think any of us ever dreamed that this project would be the size and scope that it is. But here we are, 73 doctors, dentists, optometrists, nurses, and non-medical volunteers, representing more than 40 Rotary clubs in 10 countries, coming together for the benefit of kids who have little or no access to medical care.

I would be remiss if I did not mention my wonderful co-team leader, DGE Connie Spark (D-7390), the ultimate mission guru, who has taught me so much in this process, and our indispensable and long-suffering assistant, Peter Sotheran (R.C. of Guisborough & Great Ayton, UK). I can't say "THANK YOU" enough to both of you!

There are many reasons why so many people from so many different countries would give up two weeks of their time to travel to a far-away land to work very hard in less than optimal conditions. No doubt some of their stories will be told, as we work together and share the fellowship of each other and our fellow Rotarians in Nairobi.

For now, all of the lists have been made (and lists to remember the lists), supplies and equipment ordered and almost packed, flight and hotel arrangements confirmed, questions answered, jittery nerves calmed, and the last-minute throwing of stuff into suitcases is underway. The early arrivers have already reached Nairobi, others are enroute and the last of us will depart tomorrow. Our grand adventure is about to begin!

 

Saturday, September 20, 2008

Off We Go!

By now Peter (from the U.K.), Janice (from Australia) and some of our other team members have already arrived in Nairobi. Today they will head out on a shopping expedition to purchase some supplies that somehow got left off our "take-along" list: basins for the dentiststs to use to clean and sterilize their instruments, dishwashing soap, plastic sheeting to cover our exam tables, paper towels, and so forth. We have strict instructions not to breathe a word to Peter's wife Sue that he's going s-h-o-p-p-i-n-g. Normally, Peter doesn't shop and he doesn't want to give Sue any ideas, so our lips are sealed!

While they are doing the last-minute tasks and touring the sites where our camps will be held, the rest of us are either winging our way to Africa or packing the last of our gear and heading to the airport. The 10 of us leaving from Atlanta will arrive on Saturday evening.

I'm told that the slums of Nairobi are the most notorious in the world. About 60% of Nairobi's 3 million people live in these areas (known to the locals at the "swamps"). Mathare, Mukuru and Korogocho are the largest and our camps will be located in all three. Many of the children who live here have been orphaned due to AIDS. It is those children we seek to serve.

John Glassford (R.C. of Coolamon, Australia) knows these areas well. In the fall of 2007, he organized a group of Rotarians and friends to climb Mt. Kilimanjaro to raise funds for school fees, uniforms and supplies for the AIDS orphans of Mathare. At the end of their successful venture, his team visited Mathare and John sent me photos of the area and the children. I have kept them in constant view as our medical mission was being planned.

One of John's fellow climbers, Sharon Daishe (also a Rotarian in Australia), was so touched by what she saw in Mathare that she will be joining us for the medical mission. Thanks to John, we also have several other team members coming from Australia.

Many people have asked why we're doing this project. The answer that immediately comes to mind is: because we can. Leaving behind family and friends and all the comforts of home isn't easy, but then nothing worthwhile ever is. We have been given the talents and skills and abilities to do this work and sometimes that means stepping out of the comfort zone. If we all sit around and wait for somebody else to do it, nothing will ever get done. Maybe we can't save the world, but perhaps we can at least make a small dent.

Now ... on to Nairobi! Tuesday, September 23, 2008

The Mission Team in Action

Today was our first full day of work and this evening we're all feeling the effects of it. Monday had been our "shakedown" day - setting up our work stations, determining how the registration and patient flow processes would work best and then doing a dry run of everything for a few hours. So today, having sorted out most of the kinks, we had a full day of seeing patients.

Making our way into the slum area for the first time yesterday was very emotional for all of us. Many of us have been to Africa before and, if not to Africa, at least to other large cities in the world that had slum communities. But we all agreed that nothing could have prepared us for the slums of Mukuru. Here some 500,000 souls live and move, but have no being. For all intents and purposes, these are the forgotten souls - forgotten, that is, to most of the rest of Nairobi society. In a way, it's not surprising.

The streets (roads?) that wind their way through Mukuru are hopelessly pot-holed and ragged. Heaven only knows how long they have gone without maintenance, but it must have been a very long time. Lining the streets are one shop after another: dress shops, produce stalls, meat markets, pharmacies, print shops (albeit without any visible printing equipment), and on and on. What sets them apart from other shops in the city is that few of them are larger than 10' x 10', with dirt floors and the roofs (if any) are either tin or cardboard. How these shopkeepers manage to sell anything at all is anyone's guess, as there is no other visible way of earning a living to pay for the items on sale here.

Every street is teeming with people - walking along the roads, gathering in the storefront openings, darting in front of any autos that happen to pass by - just wall-to-wall people. A glance down any alleyway reveals what passes for homes: dark, narrow openings with no visible furniture. Like the shops, the homes have dirt floors and are walled and roofed with tin or cardboard. Neither running water nor indoor plumbing exist here, so very few blocks there is a row of filthy, smelly latrines. At various intervals, as well, are large containers of water of questionable quality, from which the women and children fill water jugs to carry home.

It is nearly impossible to adequately describe the poverty, filth and hopelessenss of this area and yet all the children we see along the roadsides are smiling and waving and shouting, "How are you?" For most, it's the only English they know, but they use it liberally and proudly to hail our arrival. They want to touch us and have their photos taken, but mostly they want to be noticed. They want the fact that they exist to matter to someone and to us it really does.

So on Monday as we were setting up and getting ourselves organized, we also had a few meltdowns. More than one team member needed to slip away for a bit of a cry before they could continue. Then, having gathered themselves together, they returned to the clinic and proceeded to work. There will be more such instances throughout the week. It would take a very hard heart not to be moved by what we're seeing.

So today, we had to put all that aside and concentrate on some really sick kids. We saw many dozens of them today and we can honestly say that we saved some lives. Most of the children could be treated with antibiotics, others with careful wound treatments, but I fully believe that two in particular would not have lived through this night without our intervention. They are tiny, malnourished, and very sick twins who were so desperately dehydrated that I despaired of being able to get to the hospital soon enough to save them. Thankfully, we were able to do that, so at least for now they're still alive. One wonders what kind of life they'll face even if they do live, but we can't worry about that. We've done a good job today and we fell really good about that - not only because of the twins, but because of all the other children whose infections we could treat, whose pain we could ease, whose wounds we could clean and treat, and who will see well because they will get glasses. All in all, a pretty good days' work.

In the process, we the team members are experiencing the joy of each other, as we adapt to each other's manner of speaking, styles of work, and personality differences. I've heard a lot of laughing in the past two days, as we discover interesting tidbits about one another; however, the most fun of all is seeing what can be accomplished when a group of very diverse people are focused on a single goal, as we are.

So tonight we rest our weary feet and backs and heads and prepare to go out tomorrow and do it all over again. Day 3 - 9/24/08

We had hoped to see and treat 3,000 children while we were here, but we blew past that number today. Over 1,000 in the medical clinic at Mukuru alone today. Add in the 500 (approx.) in our dental and optical clinics at Mukuru plus the dental clinics at Mathare and Korogocho and you can get an idea of how many people are bringing their children to be seen by our teams.

Today was my turn for a meltdown. I've tried to remain stong and unemotional, but sooner or later the enormity of the situation is overwhelming and today it really hit me. Thankfully, Harry Mugo (R.C. of Nairobi North) appeared in time to whisk me away to his club's noon meeting. Much as I hated to leave the camp while everyone else was working so hard, the Mission Director was in need of an attitude adjustment and what better setting to do that than in the company of my friends in our host club. Besides, I think the team were secretly happy to have me out from under foot for a while.

By way of stark contrast to the slums, downtown Nairobi is spotlessly clean and bustling with the energy of many another large international city. The route into the city is lined with jacaranda trees, decked out for spring in their brilliant lavender blooms. Nairobi North meets at the Intercontinental Hotel, which truly lives up to its first-class reputation. So you can only imagine the very strange looks of its prosperous guests as I made my way through the lobby, still in my soiled scrube, rumpled t-shirt and grubby work shoes, with a fanny pack slung around my mid-section with a stethoscope dangling from it. Not exactly what they're accustomed to seeing in that place. Luckly, Harry whisked me through to the meeting room. Otherwise, someone might have stuck a mop and broom in my hands. It's nice to have friends in Rotary.

We returned to the camp after the meeting, winding our way through the crowd waiting outside the camp gate. We reached the gate only to find it closed for the day to any further patients. Once inside, we found the campground a sea of people. My heart sank as I realized that treating them all would be impossible, no matter how long we worked, so some tough decisions had to be made. So with great reluctance, we turned away those who were not urgently in need of care. Tomorrow would be another day and we could only hope they would find their way back to us. Day 4 - 9/25/08

We have a magician among us and his name is Darsi Lotay. An elegant but quiet and unassuming gentleman, Darsi has pulled many rabbits out of hats for us in the very best way. All it takes is the mere mention to Darsi of anything we need and within a few hours it appears.

On Tuesday, we needed a very large tent to shield the waiting children from the hot sun while they waited to see the doctors, dentists and optometrists ... and PRESTO ... a tent appeared, along with some able-bodied young men to set it up. More syringes for the dentists, additional medications, you name it, Darsi finds it, quickly, efficiently, and affordably. We will never be able to thank him enough for his help, yet it is her to is thanking us over and over again for being here.

On this day, we left camp early to freshen up a bit before attending a reception in our honor, courtesy of the U.S. Embassy. The opportunity to spend a few hours relaxing and socializing after four long and very tough days of working was met with mixed emotions. As grateful as we were for the recognition of our efforts, many of us couldn't stop thinking about the children we'd seen that day and the others who would languish that night in the hovels and alleyways of Mukuru without any food, while we enoyed a magnificent evening with more than we could possibly consume.

Still, the team needed a break and some time for fellowship and unwinding, so we spruced ourselves up in tem t-shirts, laying aside our dusty scrubs and stethoscopes and headed into the balmy evening. Day 5 - 9/26/08

It's no longer a matter of pulling out something clean to wear this morning; it's a matter of finding something less dirty. Carving out time to do laundry has not been our first priority. The buses we've hired to take us to the campsites arrive at the hotel at 7 a.m. For most of us, our day begins two hours earlier. No alarm clocks needed. A very noisy rooster somewhere nearby handles the job quite efficiently and promptly at 5 a.m. The hotel staff provides us with a full and hearty breakfast. It's far more than most of us would have at home, but we will be working hard and it will be a long time until lunch.

By 7:15 a.m., the wheels on the buses are rolling toward the campsties with team members and gear onboard. Nearly an hour later, having threaded our way through rush-hour traffic, we arrive at our destinations and get to work.

In the afternoons, we must leave the camps by4 p.m. if we want to spend only one hour getting back to the hotel. Otherwise, the commute can easily turn into two hours or more, which in a hot and bumpy bus isn't anyone's idea of a good time. The 8 hours in between sound like a rather short working day, but I would challenge anyone who thinks that to walk in our shoes for just one hour.

Although it's springtime in Kenya, with blessedly cool and breezy mornings and evenings, we are less than 100 miles south of the equator. Once the morning overcast burns off, the sun is intense and relentless. Some of the modern high-rise office buildings in the city center have air-conditioning, but here in the camp it's a different story. So when the heat of the day exceeds 80 degrees, it takes a toll on us all. In addition, Nairobi sits at about5,500 ft. above sea level. By now, we're mostly accustomed to that, but it still factors in to fatigue.

Once we stumble off the bus back at the hotel at the end of the day, the poolside bar does a brisk business. Although this is a budget hotel (think Holiday Inn before renovation), the pool area is quite lovely and provides a great place to unwind.

Evenings have been times of fellowship. Some have adopted Connie's philosophy: We can sleep when we get home. They've tried different restaurants every night and have enjoyed the wide variety of food that Nairobi has to offer. Others of us, who crave our sleep, tend to stick closer to our hotel/home, where the restaurant does a very creditable job of providing a satisfying dinner. Either way, we have a chance to share our day and our lives and bond ever more closely. For now the laundry can wait. Day 6 - 9/27/08

This was our biggest day yet. If our patient flow continues as it has so far, we will have seen and treated about 12,000 kids by the time we close the camps next Tuesay. In our wildest imaginations, we could never have predicted this result.

Publicity-seeking is not my style. Generally, I prefer to fly under the radar and away from the glare of the flashbulbs. Here in Nairobi there's been no such luck; however, in this case it's been a good thing. Attention from the media, which has intensified as the week has worn on, has brought about the very best kind of result.

From the beginning, many of us have wondered what would happen to these children when we go home. Will anyone follow after us, or will they continue to be the forgotten ones? Today we learned the answer. Already plans are afoot to convert our mission camp site at Mukuru into a permanent children's clinic, thanks in large part to some significant funding from the U.S. government. Normally when I hear that our government is funding yet another social program, I would roll my eyes and cynically mutter, "Your tax dollars at work." But somehow this time is different. We have lived among the people here and have seen firsthand their needs and their efforts to help themselves. We have watched them eagerly soak up information about healthcare and wellness; we have experienced their enthusiastic assistance to us, turning out in droves to help in the camp in any way they can - even when the help we need is scrubbing dirty dental instruments and keeping our workspaces clean. No task it too menial for our Kenyan volunteers to accept. If our mission here has been the incentive for a new clinic in this area, as we've been assured that it has, we will have contributed to giving people a hand up, rather than a handout. What better legacy to leave behind than that! Maybe the publicity we've received isn't so bad after all.

The Kenyan people whom we're serving have not been the sole beneficiaries of our mission here. We, too - every last one of us -have been on the receiving end of a wealth of knowledge, experience, friendship, fellowship and yes, pure joy. Those of us who have been in the medical profession for a long time have grown accustomed to relying on medical science by way of fancy diagnostic tests and tools and high-powered medicines. Here we don't have those luxuries. We have only our hands, our eyes, our ears and our gut instincts to go on. Not exactly modern medicine ... and yet, we have honed our powers of observtion and our listening skills and learned to make do with what we have.

In the mission camp, the kind of medicine we practice is more art than science - at times more folk art than fine art - practiced more with the heart than with electronic gizmos and gadgets. In the process, I have seen the inner beauty of my team members shining through, as they cooperate, collaborate, communicate and share their special talents and skills with each other to provide the best care they have to offer to these little ones. The children we are treating probably won't see our faces again and certainly won't remember our names, but we will never forget what we've learned and experienced while serving them. Day 7 - 9/29/08

On the seventh day we rested ... sort of. Most of us chose to sleep in a bit. That didn't stop the rooster from crowing, but today we didn't have to rise to his wake-up call. What a luxurious feeling to have an entire day free to do as we pleased!

Last night we were honored at a gala event, hosted by the dynamic duo of Rotary District 9200 Governorn Kaushik Manek and Asst. Gov. Geeta, his gracious wife. U.S. Ambassador Annenberg was among the guests who numbered nearly 300. No Rotary event would be complete without a few speeches and this night was no exception. Then we were treated to a lavish meal, after which the dancing began. All in all, it was truly a magical evening and the clock had struck 1 a.m. before our coaches turned into pumpkins. (Eat your heart out, Cinderella!)

After all of the wonderul food we've consumed this week, it's a wonder that any of us have clothes that still fit. Apparently, though, we're walking, working, and sweating it off, as no one seems to have gained an ounce.

Rest Day found some of our group heading off to church, while others went shopping. Still others of us did our best imitations of couch potatoes - at least for a while. But the lure of a cookout was too much to resist, so off we went to an afternoon with Darsi and Dr. Barbara - a barbeque, Indian-style, where the men do all the cooking and the women get to sit around sipping wine and nibbling on hors d'oeuvres all afternoon. Definitely a concept worth exporting - the sooner, the better!

I expected the conversation this afternoon to include expressions of homesickness. Instead, the big questions were: "Can't we stay in Nairobi a little longer?" and "When are we coming back?" and "Where are we going next year?" Talk about shock and awe! All along I'd been concerned about working people too hard here, but already they're wanting to go out and do this all over again. Perhaps the heat is causing them to hallucinate. We'll find out in the next two days. Day 8 - 9/29/08

Our luck almost ran out today. We've enjoyed perfect weather the entire time we've been here. This morning, however, was especially cool. Fat dark clouds covered the sky and the air felt heavy with moisture. A light drizzle dampened the windshield a we drove to the campsite. Slipping scrub jackets on over our t-shirts to ward off the morning chill, we wondered if this would be the day the rains came.

Luckily, by mid-morning, the clouds began to move out and the sun popped through to chase them away. The jackets came off, sun hats went on, and we breathed a collective sigh of relief. It was going to be another beautiful day.

Today the crowd on moms and children was a bit smaller. We are no longer the curiosity we were when we first arrived. The community leaders have apparently pronounced us fit for duty.

With every passing day, more and more volunters show up to help us and we are very grateful for their presence. Local third- and fourth-year medical and dental students have been on hand to work alongside us as translators and valued assistants. Local non-medical volunteers have helped with registration, crowd control, patient flow, and a wide variety of other tasks. In addition, Rotaractors and members of the Rotary Clubs of Nairobi North (our host club), Nairobi, Karen, Utumishi and Muthaiga, as well as Rotary Community Corps members have been on hand to assist us. Our pharmacist, Dr. Brenda, and her cadre of pharmacy students have provided their efficient services and local health educators have conducted wellness and nutrition information sessions to many hundreds of parents while they waited for their children to be seen by the medical staff. In short, we've had an army of local volunteers.

Prior to the mission, our non-medical volunteers on the international team wondered what on earth they could possibly contribute. I believe they all know the answer by now. All of them have been stars in their own special ways. One to whom both Connie and I owe very special and personal thanks is John Kirkwood (R.C. Jinja). John drove his big, burly 4x4 from his home in Uganda for 10 hours to get here. He had signed up for the mission less than one week before we departed and I have no idea what we would have done without him. John ferried Connie and me back and forth every day from hotel to campsite and back again, so that we could run the inevitable daily errands to the Nakumatt (Kenya's version of Walmart), the bank, or wherever else we needed to go. During the day, he made himself available to work anywhere he was needed and also did ambulance duty when we had a critically ill child who need more advanced emergency care than we could provide. More than one life was saved this week thanks to John.

NOTE: to any Rotarians reading this message ... John's club could use our assistance to purchase a van for transporting sick kids in his hometown of Jinja. I'm going to need some $$ help putting this project together, so please let me know if your club is looking for a good project.

Meanwhile, back at the camp ... a slower day today means we probably will not end up treating 12,000 children. Our final number is likely to be closer to 10,000. A bigger number would have been nice; however, we didn't come here to set records; we came to provide the best care we knew how and I truly believe we're doing that. Day 9 - 9/30/08

The breakfast room on this morning was very quiet. This was our final day in the camps and melancholy feelings were setting in. Around the room I could see silent tears beginning to fall and team members clutching each other. We are all thoroughly exhausted, but we have shared a very special time together. Our emotions have run the gamut from high-high to low-low and we have formed friendships that will last many years to come. Somewhere in the parallel universe we call "home," our families and friends await our return. We miss them terribly, but leaving each other and this place will be very hard. A full day's work still lay ahead and we were going to need a large supply of tissues to get through it.

Our patient flow today was steady but not frantic. The slighly slower pace, when we can afford it, gives our team more time to spend teaching the moms how to prevent the illnesses we're seeing. Throughout the mission, our team has done an outstanding job with the education piece of healthcare, but some days they've felt rather rushed, knowing how many patients were still waiting to be seen. Today and yesterday, that hasn't been the case.

The concept of illness prevention here is still very new and a plan to implement it sorely needed. Based on what we've observed, many of the basic components already are in place even in the slums. Fresh fruits and vegetables are available in abundant quantities and varieties at affordable prices. Likewise, eggs, milk, and other sources of protein and calcium. People in the slums must walk nearly everywhere they go and even though there are few actual playgrounds, the children run and play in any open space they can find. At least a few homes have TV; we've seen the big satellite dishes, but they don't seem to lure the children into a sedentary lifestyle. Childhood obesity is not an issue.

What the people here need most, it seems, is a few good health educators to help them connect the dots: wash your hands, boil your water, brush your teeth, eat your veggies: very simple and basic stuff. That's not to say the job will be easy. Old habits die hard, as we know, but creating new ones isn't impossible. I sat in on a few of the sessions in our camp being conducted by local health educators and was pleased to see hand shooting up all over the room during the question and answer periods. Kenyans tend to be quiet and soft-spoken people, so their eager responses were all the more indicative of their desire to learn. The sessions were conducted in Kiswahili, most of which I couldn't understand, but the body language and reactions of the audience were enough to convince me that they were tuned in.

During the many times I've been interviewed here by the local media and officials from the Kenyan Ministry of Health, I've been asked what could be done to improve the conditions here. In every case, my mantra has been: clean up the trash and get to work on illness prevention and health/wellness education. I hastened to add that I'm not an expert; these are just my team's observations. We'll probably never know whether or not what we said has made any difference, but given the opportunity to speak, it doesn't hurt to try. End of Day 9 - 9/30/08

Toward the end of our last day in camp, the waterworks flowed freely. So many children have passed through our hands; now we can only hope they don't fall through the cracks. We've been told that the data we've collected will be closely analyzed. Our patient information forms are proving to be the best random sampling of the status of childhood health in this area that has ever been done - yet another very positive result of our being here.

No one was eager to see the last patient leave, but we had to close early to pack up our gear. The international team members exchanged small gifts with their Kenyan counterparts and hugged each other tightly, no longer reluctant to weep openly. Hundreds of photos were snapped in a final attempt to capture our time in this place. Personal supplies were sorted and crated for shipping home (more than 22 cases for the optical team alone) and excess supplies from grant funds prepared for transport and distribution to other local clinics.

When the final crates and boxes were locked and stowed, the Mukuru crew gathered for a huge group photo with some of our new Kenyan friends. Trying to edit out the "red eye" in this photo would be impossible; there are too many to count and the red eyes are all real.

As the international team members boarded the buses for the final time, the leaders of the Kenyan continent called me aside. "Will you please do one more thing for us?" they asked. Then leading me to the center of the courtyard, they showed me a freshly dug hole in the ground. Beside it sat a small tree, waiting for a new home. "We'd like you to plant this tree," they said, "to commemorate your visit. When you plant a tree in a place, it means you must return." So I knelt in the dirt in my scrub pants and gently planted the little tree and watered it in.

Some day, our little tree will see a new clinic rise here because 73 people from 10 countries put Service Above Self and traveled here to Make Dreams Real. Well done, my friends, well done! Mission Accomplished!

Our final day in Nairobi has arrived. Before this day ends, our group of 10 who flew out of Atlanta 12 days ago will board our fight to Amsterdam and head for home.

I believe it was Stephen Covey who once wrote that the four basic human needs are: to survive, to learn, to love, and to leave a legacy. I believe we have done all that ... and more. We also have all been reminded that the best things in life aren't things. That was proven to me very early in the planning process when I first began working with my co-team leader DGE Connie Spark (D-7390). For the past seven months, she and I have worked six to eight hours a day (and sometimes more) for at least five days a week to put this project together, including an hour (or two) each day, collaborating on the phone. I'm sure those who know us would agree that we are both very strong personalities, yet in all of that time, not a single cross word passed between us. I feel very blessed to have worked with Connie and I hope we will do many more projects together.

A heartfelt THANK YOU to my long-time friend Peter Sotheran, who threw himself into this project and did such a great job of arranging our hotel accommodations, ground transportation, daily lunches at the campsites, and many more nitty-gritty details.

There are many more people who deserve special thanks and we'll do that privately. Meanwhile, there's one more day to take in the sights and sounds of Nairobi before we fly out tonight. Some of the group will head downtown for a bit of last-minute shopping. For me, it will be one last Rotary meeting to attend at noon, after which I think I'll have enough make-ups to last for the rest of the year.

I don't think any of us will ever eat another sandwich without remembering lunchtime in the camp at Mukuru. Try as we might to find a secluded spot to take a quick lunch break, we could never escape the hungry gazes of the little ones who typically get only one meal a day. Tired and famished as we were, we couldn't bring ourselves to eat in front of them, so many of us gave away at least part of our lunches and contented ourselves with sneaking bits of granola bars when no one was looking. I found one wee tyke eating toothpaste after her dental check-up and slipped her a granola bar, too, which was mowed down in an instant.

Students from the vocational school across the road brought us steaming cups of chai tea and sweet pastries every morning. For some reason, those didn't appeal to the children, so we enjoyed them without feeling guilty.

Many times I wished we could have brought along a supply of soccer balls. Surely I could have found a tire pump somewhere to inflate them and what a wonderful novelty that would have been ! Kids here enjoy playing soccer and in the absence of real soccer balls, a wadded up bundle of old plastic bags tied up with strips of cloth becomes a make-shift ball. Unfortunately, we can't do everything that needs doing here, so perhaps this time it was enough to come and do what we do best.

I must take a moment to apologize to friends and family for not bringing home any souvenirs to share. All of you know me well, so it should come as no surprise that I have spent all my free time here networking and "Rotarizing" rather than shopping. Opportunities like this don't come around every day and I will find other ways to repay your many kindesses and magnanimous support.

To my second family, the Rotary club of Marietta Metro, and my extended family in District 6900, a thousand thanks for making this mission possible. I hope we made you proud!

Now we must say "Asante sana" Nairobi. Thanks for the beautiful memories, warm hospitality, treasured friendships and special times of fellowship and service together. Mission accomplished; it's time to go home.