We work at the African Inland Church clinic, which is a mission based outpatient clinic that serves mainly the Maasai people of this area. We get up at 6:30 am, eat breakfast, pack our stuff and get ready, leaving for the clinic by hopefully 7:15. Sometimes it’s later than that..which is ok because we are on African time 🙂 It takes us a solid 45 minutes to walk there, and that’s at a pretty solid pace, not just leisurely walking. There is a devotion time with the staff starting around 8 or 8:10..which some days we go to and others we spend that hour counting out meds, cleaning, and preparing for the day in the clinic. The clinic starts taking patients at 9. People file in, register at the reception desk, and then sit and wait. Pretty typical. But the scene is so much different. I wish I could show you pictures. The people coming in are Maasai, adorned with their brightly colored wraps and lots and lots of beaded colorful jewerly. Mom’s have their babies strapped to their backs with wraps. The clinic was not built to be a clinic and dispensory, it was built to be a dorm for kids who live there for the rehabilitation center that is part of the compound. Needless to say, the set up is not the most convenient for the sometimes masses of people who file through each day. It is crammed. The waiting room has only 5 benches, all of which are typically pretty squished full. It overflows outside, where there are a few more benches, and where people sit or sometimes lay in the dirt. It is typically loud, smelly, and very packed. Our consistent job that we do independently is to call out names and do vitals on our patients. I’m getting to be an expert at this manual blood pressure thing 🙂 Where we see patients is on the opposite side of the waiting room of where we need to take cards back to the reception desk for the nurses to pick up. Which means a lot of trying to weasle my way though lots of people. We also get to go into rooms with the Kenyan nurses and see patients, help examine, give injections, weigh babies. There aren’t any doctors there, just 3 nurses (plus one volunteer nurse who is leaving this week..so we’ve had 4 the past couple weeks), a receptionist, a lab tech, and a pharmacist. We see a lot of malaria patients, people coming in for HIV testing or treatment, mom’s with babies who are sick or need immunizations, a lot of maternity patients for prenatal check-ups, eye patients (because we have a nurse who is a trained eye examiner here), infections, worms, anemia, malnutrition. It has been really interesting to sit in and see these cases. It is so different than what I’m used to: a different language, different culture, different diseases and sicknesses, nurses seeing patients diagnosing and writing prescriptions, different resources, plus I’m so used to inpatient from my clinical experience that it is weird to sit in a room and wonder what of the wide spectrum of complaints the next person may come in with. I’m catching on to how to look at the symptoms that are translated for us and put them together into a logical guess of what might be wrong with our patient. Some of the things I’ve been honored to sit in on (some super great others super sad) are:
-hearing a baby’s heartbeat in utero, using a fetoscope. Which is basically a double ended cone that is placed up next to the mom’s pregnant belly! Quite different than the ultrasounds we have
-seeing patients come in for HIV testing. Seeing the relief and immense joy that comes with a negative result. And being present in the devestating life changing positive results. I was in a room with a 13 year old girl who came in with pretty advanced HIV but didn’t know it..it was heartbreaking
-learning to examine pregnant mothers. Hopefully bringing some comfort by my love to the extremely young ones who come in alone looking so scared. In the culture here it is not unusual to see young girls (sometimes as young as 11-13) married off to a middle aged man. The men can have multiple wives too. Mostly the mom’s come in alone, the men don’t come with them.
-weighing cute tiny babies
-giving IM injections. Sorry OSU nursing, we do give the dorsal gluteal injection here. I don’t know my place to change practices they have here..these nurses may not be the most thoroughly educated in the Western sense but they are very experienced and do their job excellently.
Some days are busier than others. Wednesday is by far our busiest day. Because it is market day people come into town, so they come into the clinic on those days as well since they can walk for miles and miles from their homes in the bush. It is also the immunization clinic day, so mom’s come in with their babies to get them immunized. Thursdays are slow days..we thought this would be our day off but we have yet to have a typical week so we’ve been there the past 2 Thursdays.
Some crazy things: you never know when the clinic will have electricity. It is more often than not on, but even then there’s only really one light in the waiting room and small lights in other rooms. The clinic has no running water. None. There are no doctors. The rooms we see people in are very tiny..I wish I had an accurate guess..maybe like 6 foot by 9..at the most. The Kenyan staff hardly ever wears gloves..they are in short supply. The lab tech does..but I’ve seen other staff give injections, and even prick a finger for an HIV test without gloves. We take temperature with an in the ear thermometer, which they didn’t change the disposable sheath or alcohol swab it at all when we got there..we have been though, adding a little sanitation education. There are basically 2 examination rooms, but sometimes the administrator’s office becomes one, or the room that is open to the waiting room where we normally take vitals becomes one..depends on how busy it is. With the limited resources, I have been amazed at the level of care the staff provides. And even more so, I’m amazed at the staff’s passion, devotion, and compassion for loving God’s people. They are strong Christian men and women.
At first I really struggled with how to really make an impact at the clinic. I don’t know the language, how am I supposed to connect to, provide care for, love on, or educate my patients. But I’m learning a little Swahili – enough to give instructions to my patients. Plus, we provide comical relief for our patients as we call out names or as children burst into tears at the sight of us wazungu (white people). (Also, small grammer lesson in Swahili: the prefix wa- is plural and the prefix m- is singular. I’m learning 🙂 But most of all, I’m learning how God’s love and compassion and comfort can fill me and pour out of me even when I can’t speak the language.
“When the Son of Man comes into his glory..All the nations will be gathered before him, and he will separate the people one from another as a shepherd separates the sheep from the goats..Then the King will say to those on his right ‘Come, you who are blessed by my Father; take your inheritance..for I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.’ Then the righteous will answer him, ‘Lord, when did we see you hungry and feed you or thirsty and give you something to drink?’…The King will reply, ‘I tell you the truth, whatever you did for one of the least of these brothers of mine, you did for me.’ ” Matthew 25
and “Freely you have received, freely give.” Matthew 10:8
In the first passage, Jesus doesn’t say that our faith includes talking in depth to lots and lots of people, or sharing the gospel in words, or even using my words to tell people about what he’s given those who know him. It is physical acts. Giving, taking people in, feeding, looking after the sick. It is loving people. I can do that with my patients even if I don’t know Swahili or Maasai. Is it helpful to communicate my faith if I had words? Yes. But I don’t. And I have been filled up by Matthew 25. God has been transforming my heart and training my eyes to see the sick people who sit in front of me every day as him. And when I love them, I love him. And I hopefully show them at least a glimpse of his love for them. And the second passage, well..I’ve received freely. I’ve received material wealth in this world, a good family, being born in a place not torn by poverty or war or corruption, education (yes mom and dad I realize we pay for this..but the opportunity was still handed to us), etc…all freely. Meaning God has blessed me with these things. But even moreso, I’ve been freely given the gift of life, eternally. And so I’m not commanded to be tightfisted and hold onto my wealth, whether material or the wealth I have from knowing Jesus. But instead to give freely. And God has really been putting that fire in my heart to go to the clinic and pour myself out as much as I can. Because it’s not really me I’m pouring out. I’m pouring out of what God has filled me with, I’m pouring out because of the abundance of the Holy Spirit he has freely given me. And when I come home at night, physically, emotionally, and spiritually drained, God has been faithful in filling me back up. Giving me enough energy and strength and love to pour out to the kids. And then again, filling me up so I can do it again the next day. I don’t need to be stingy with my energy or my love, because God is providing.
That’s all for now. Time to play with some cute kids 🙂