Jambo Mambo -

Well today is day kumi (ten) and I am close to the halfway mark of my twenty-one days in Kenya. It is surreal that I am where I am, in terms of my experience, before I got here I no idea what to expect and now I am jumping on matatus and navigating through the suburbs of Kenya. But I am still a muzungo (word for white person).

Yesterday was really nice. I got to see my friends Lee-Anne and Marcus who were in Kenya with Lee-Anne's Dad and step-Mom visiting some friends of theirs. There friends are a Canadian couple who live out in the Masai Mara and work for one of the nicest hotels in Kenya, the Serena House (sp). This hotel is in the midst of the Mara overlooking African wildlife as they live day-to-day. This Canadian couple operate hot air balloons that fly over the safari land, the man operating the balloon, while the gal takes professional pictures. The six of them were a breath of fresh air and a little slice of home for me. They took me out with them for sushi dinner which I am extremely thankful for. Thank you Ray, Lee- Anne and others.

I was at the clinic again today. I worked in the dispensary and treatment room again but instead of handing out medications I was more or less the pharmacist today. I was repackaging all the medications as the pre-packaged medication supply was starting to run low. A lot of the standard prescriptions are pre-filled to make things operate a lot faster. I am not sure how pharmacists or their assistants back home stay sane but I have a whole new respect for 'pill pushers'. To my friend Margie in Vancouver, I am glad you did your clinical residency. Congrats.

Intermittently between counting amoxyl, paracetamol, piriton, and ibuprofen tabs, I was also operating the treatment room again. The first patient I saw was a local construction worker. This vocation in Kenya is not nearly as guarded from hazards compared to the standards back in Canada. A lot of the construction here happens with archaic machinery, even machetes, and little to NO safety gear. Furthermore, the scaffolding is made out of thick three branches and bamboo stocks (speaking of, it is so frequently seen here that I will try to get a picture for next time).

This construction worker was a middle aged man who came in with a cloth wrapped around his thumb, with his primary complaint being a 'cut' to his left thumb. He had told the nurse in the assessment room that he cut his thumb on piece of metal. She sent him to the treatment room to see me with an adjoining script that ordered for a tetanus shot and a clean dressing to be applied over the wound. When I got the patient up on the bed and unwrapped the cloth around his thumb I saw that his thumb was pretty much cut in half starting at the top of his thumb and working its way down splitting the nail in two. Very appetizing.

I had to try my hardest to stay composed. I left the patient in the room while I went to consult the nurse and describe to her what it looked like, as she clearly did not assess it herself. I explained that he may need something more than just a dressing. She wrote a referral to the nearest hospital for suturing - as we don't do that in our clinic, nor do we have the supplies even if we wanted to - but before he left I had to clean the wound and redress it. Gag.

The doctor finally came into the clinic today around noon. He was accompanied by three contractors, as the doctor is trying to make a few improvements to the clinic. When we took our chai tea (the national drink here) for the afternoon we were interrupted by one of the Kenyan school teachers from the Rehabilitation School adjacent to the clinic. It was the science teacher from the school and he was requesting syringes from the clinics supply. Before the doctor responded to this request I immediately felt tension in the room and thought that this was an odd teaching supply for a teacher to need.

The doctor asked the teacher what it was he wanted the needles for - as he has to account for his supplies which are rationed by the government - but the teacher instantly switched from a quiet man to this angered, hostile Kenyan. He promptly stated that if the doctor wanted to ask too many questions, the he should be prepared to deal with the consequences. Followed by a gentle, give me the needles and I will be on my way. The whole time this is happening the nurse is staring at the ground and I am in complete shock at what is going down. The teacher ended up taking a bunch of our prepackaged needles, which surely will be sold on the streets tonight. After wards, the doctor didn't really bring the subject up again, so I think he was a bit embarrassed at what happened.

Later on during our tea session the doctor explained the circumstances involving the post-election violence of 2007. In a VERY short, non peer reviewed version based on my talk with Dr. Ashiembi, this is what I gathered. He told me that the current President of Kenya had the electoral body change the name on the winning election ballot as he would have lost to the current Prime Minister. Since Kenya is composed of nearly 43 different tribes only a few tribes were/are represe the 38 other tribes attacked and took out their anger on the four tribes whom are represented by the corrupt President.

It took the United Nations and a few African organizations to come into Kenya to break up the violence. Many people were further displaced because of this violence and further increased the number of people in the IDP camps. The next set of elections are in December of 2012 and many residents here are concerned that this may happen again. Dr. Ashiembi further elaborated on many corrupt schemes played out by the government, including the ginormous salary government officials are paid. At the end he said that Kenya has tried to vote into place a leader to lead the nation but they always end up with a King who feels entitled to whatever he wants.

Just another interesting day in Kenya. I hope that what you take from this a realization that things happen very differently in remote parts of the world. As a Canadian, we have many checks and balances that allow us to live freely and have equality. If you can, take the time to read up on places such as Kenya or other countries in Africa and see if there is something big or small you can do to help. Even helping some cause in Canada is more than enough.

Sending my love

Jake