Clinic Days at Kiseke

Our team at Kiseke, with Marilyn holding the Elmira newspaper, I think!

From my journal September 24, 2009

"Clinic Day One in Kiseke. Today was a blessing!  As Aron, our Lab Tech said, 'God knows that you had  busy day yesterday and that you are tired and so he has given you a slow day today because tomorrow will be busy again'.  He is so right!"

Aron, our Lab Tech from Urafiki...incredibly hard worker with a beautiful heart!

Having survived our 400 plus people day at the Bugando Clinic, we were indeed blessed to see just under 100 people our first day at Kiseke.  Yes...we were tired and weary.  The second day though...word got around the area and we saw about 270 people.  So much need so we were happy the word got around more.

Kiseke is not far outside of Mwanza Town and it is a growing area.  Our clinic was actually set up in an existing Clinic in the area...quite a beautiful clinic actually.  Apparently, the funding has not been there to support it staying open and so sadly, the doors to it are closed and locked.  There is a portion of the building that is being used to teach sewing for the local women...to train and enable them in employment.

As RN's we switched our roles up every other clinic day or so, rotating between triage, consulting and the Pharmacy.  It was a great way to be exposed to each role and to really appreciate that work that goes into each position.  The Pharmacy is a funny place because at the beginning it's pretty relaxed since no one has gotten through the Consult area yet and received prescriptions for anything!  Once it gets going though...and right through to the end of the day (longer than anyone else) it is busy, busy, busy.  It's a place of great responsibility because the distribution of medications is serious business.  We had translators from the Urafiki Clinic with us and they would do the health teaching in the person's native tongue of Swahili.  It is a great challenge though sometimes to communicate with even translators, depending on their level of english.  We were SO grateful for them though because without them, we just literally couldn't do it safely.

In the midst of stress one must always try to keep their humour! This is a "pre-rush" scene of the Pharmacy at Kiseke (we had an actual Pharmacy room!!!) Note the little dolls on top of the meds...these are the ones that come packed on top of the Physician Travel Packs.  

Some highlights from Kiseke...a LOT of babies! and wonderfully so, a lot of healthy babies!  Yes, many of them had intestinal worms but that comes with the territory when playing in the dirt (and therefore eating the dirt!).  We did see one 2 week old who was positive for Malaria.  She was quite alert and active and her malaria levels were low so hopefully we caught it early enough that treatment will prevent any further damage. The reality is, she will more than likely contract it again.  Malaria is rampant in Africa! absolutely rampant.  The World Health Organization states that a child dies of Malaria in Africa every 30 seconds.  I couldn't help but think as all of these children passed through our lines for treatment in the clinics...these are the faces of the children who are dying from Malaria...they represent them. Statistically, a good number of the children I saw will die from Malaria.  Mosquito nets are the best solution...they offer prevention of the disease and yet so many families cannot afford them.

This little guy to the left was a funny little fellow.  He came the first day of clinic and then the second day of clinic he appeared again...this time with eye glasses on his face...upside down!  I have no idea where he got them from.  Most people in Africa cannot afford eye glasses, let alone a trip to an Optometrist!  Somewhere though, he found some...he just didn't know how to wear them!  He was a rare kid in the sense that he really smiled when his picture was taken.  Sure, lots of kids do, but a lot of kids also have no idea what to do when they see a camera and adults REALLY aren't sure what to do.  You can tell that they just aren't used to cameras because when you go to take their picture, they just sort of stand there with this very serious face, not sure what to do!  It takes a while to get them smiling, but once they do, it's worth it...because it captures what they normally look like!

This pic above is a funny reminder of what I was just talking about.  A mother asked me to take her children's picture.  The first photo both children were very serious and then this one, the mother must have said, "SMILE!" because the little girl threw on this huge cheesey smile!  The sad part of it was that the mother thought I could give her a copy of the picture right then and there and I had to try and describe (through hand gestures!) that I couldn't do it!  I felt horrible!

One story that stands out from the Kiseke Clinic was that of a young 23 year old male.  He was in my consult area and through the translator, I had determined the typical...he had intestinal parasites and muscle pain.  I asked him, "are there any other concerns you have?".  Well! that was when he mentioned that he has a "cut" on his right ankle (he was behind a desk when I was talking to him, so I couldn't see his legs).  I asked him what had happened and he said he three months previous he had fallen off and landed on his bicycle.  I told him I wanted to take a look at it and came round the desk.  As soon as I knelt down, the smell assaulted me!  His "cut" was a large and deep wound and as I examined the area, I noted that his right foot, ankle and lower leg were swollen.  This young man is lucky that he still has a leg! I immediately took him to a treatment area and one of the other RN's and I cleaned his wound up and amazingly, the wound base looked much healthier than we thought it would!  We had to pack it with some saline soaked gauze (because it was deep) and dress it up.  I had Dr. Mukulla instruct him to return the next day (when were were back in Kiseke for our second clinic day) and told him that we would teach him how to dress it himself and provide him with some dressing supplies.  We sent him home with antibiotics and he was off!  The next day, he was there bright and early and so I took him in first and redressed the site.  I had had Dr. Mukulla translate, in writing, some dressing instructions I had written out for him and he translated very well for me when I spoke to the young man and stated that he must take care of his leg and follow instructions or he could lose it!  I knew when Dr. Mukulla got to that part of the translation when I saw him motioning back and forth like a saw! (ie. amputation).

It's people like the young man I described above that I wonder about...how is that wound now? Did his dressing supplies last?  He can't afford to go to the hospital to have it looked at and treated...that's the reality of his life.

A few glimpses of the people waiting around the clinic at Kiseke....

Me making a little friend.

This was one of the ultimate shots! (thanks Sheri!).  We saw this woman with her baby wrapped on her back.  The material she wore had these hands and fingers on it.  There is NO way that she could have known that it would land the way it did...with the hand perfectly holding her baby's bum!  Sheri showed her this picture after she took it and she just laughed and hid her face!