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!

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.

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 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 Rannenberger 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 (although Yolanta and I somehow got coerced into helping). 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.