So this past week has been full of adventures, and I’m excited to share them. I am also beginning to understand more about the culture and lifestyle here.
But first thing’s first.
Our classes at the Great Lakes University of Kisumu (the locals call it GLUK) began on Monday, with lectures from Dr. Richard Muga, a Kenyan Professor and former manager of the provincial hospital, and Harvard’s own Dr. Thomas Burke. The lectures focused on the overarching theme of the program: the integration of modern technology at a community level that is sustainable. Sustainable, in this sense, means that it can be reproduced from local resources and not rely on donors for materials or finances, a big problem for current NGOs. One example is the medical device called a uterine balloon. One of the primary causes of death for African mothers is hemorrhaging of the uterus after a difficult delivery. The uterine balloon is already used to great effect in the United States, but is expensive and can only be used once. Dr. Burke, along with a team of Harvard faculty created a sustainable version using a cheap modified catheter and condoms tied together in such a way that when the condom is inserted into the uterus and filled with water, the pressure of the inflated condom can stop the internal bleeding. This device is still in early stages currently but it has been shown to save mothers’ lives when used by a trained medical technician. The importance of the condom is that is strong, resistant to tearing and cheap. The catheter can be reused after sterilization and the condom discarded. Technologies such as this have the potential to cause revolutionary changes in the practice of medicine in developing nations such as Kenya.
On Tuesdays and Thursdays, my project partner Jordi and I have been assigned to work with the NGO called Nyanza Reproductive Health Society (NRHS). NRHS has been operational since around 2006 and focuses on treatment and prevention of the spread of HIV among the Kisumu community. The Nyanza province, where Kisumu is located, is on the Western side of Kenya, and has the highest HIV prevalence in the country at 15%, doubling the national average of 7%. NRHS works through community outreach to educate Kenyan men and women ages 10-25+ on the dangers of HIV and how to prevent the spread of the virus. The focus of NRHS is a process called VMMC or Voluntary Medical Male Circumcision. Research has shown that VMMC reduces a heterosexual male’s likelihood of getting HIV by up to 60%, which is huge in an area where HIV is so common and takes so many lives. Jordi and I actually witnessed one of these adult circumcision procedures, when the director of medical health of the NRHS clinic let us into an operating theater. The two doctors there were efficient and extremely skilled at the operation, and the whole ordeal took about 15 minutes. More on this will come later as Jordi and I get to know the organization better and hopefully devise a way we can use our resources as students to help them solve some of their outreach problems. We will be working closely with Dr. Burke, Sean Flannery, and a few other Harvard faculty to hopefully make a difference in this organization’s mission to stop the spread of HIV.
Here is the original study: http://www.ncbi.nlm.nih.gov/pubmed/16231970
On Friday we toured the provincial hospital, which was incredible to compare to hospitals in the United States. The hospital is one of the largest in the country and has some of the best technology in Kenya, but it is still years behind every hospital in the US. X-rays are still developed by hand, machines break and are unable to be fixed for months due to lack of technicians, and many health providers still lack basic supplies such as gloves and masks. However, it is extremely inspiring to witness the healthcare providers work so hard with limited resources. I witnessed the passion and care these providers give to their patients in the face of sometimes disabling poverty. We toured the maternity and children wards, which were full of malnourished mothers and premature babies. The babies were so thin and many were born under 1kg (<2.2 lbs). Some had neurological conditions such as convulsing or fluid filled lungs caused by the degree of their prematurity. One small baby girl who was born 8 weeks early continuously vomited white mucous from her nose and, we were told, would probably not survive more than a few days. The mothers were malnourished as well and many were unable to produce breast milk to feed their infants. A major part of this hospital’s job is to help get patients enough to eat so that their bodies can fight off infection. They do so with food and nutritional supplements from countries like the US. The problem, our tour leader told us, was that if the donations were to stop the hospital would not be able to run effectively and many patients would die. However, the hospital does so many great things for the community that the visit was truly inspirational and made me even more excited to pursue medicine as a career.
On the just-for-fun side of things, the group climbed up a mountain in the Kakamega rainforest, the highest peak in 100km of the area. Along the way we saw black and white colobus monkeys, tons of butterflies and quite a few colorful birds. Close to the top was an old abandoned gold mine that has since become a bat sanctuary. The bats were about the size of mice and would fly right by my ears! Luckily, they only eat insects. I also saw a spider that was the size of a tennis ball. The internet is slow and I have to leave the cafe that I’m at, but I’ll try to post more pictures later.
Sorry this one was so long, but if you made it this far, thanks for reading! I have plenty of other pictures to put up but the internet here is so slow it takes forever. Keep checking back for more posts!