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 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 campsites 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 by 4 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 about 5,500 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 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 he who 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 team t-shirts, laying aside our dusty scrubs and stethoscopes and headed into the balmy evening.

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.

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 every 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 hopelessness 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.

But 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.

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!

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!