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| 2 patients to a bed |
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| making rounds |
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| camera shy! |
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| Simba! Yes he looks this impressive in real life. |
Thursday, January 27, 2011
Final Post
Well, back home and greeted with too much snow. We had a good time on safari although the accommodations were fair. It was wild to see all the animals so close to our van. Below are some final shots from safari as well as some pics from the hospital. All in all Sara and I had a memorable experience and we hope to return. It is clear that the rewards are great in helping those with so little. Thanks for following!!
Thursday, January 20, 2011
Lions and Tigers and Bears
Thurs Jan 21st- flying to Nairobi tonight and starting safari in Masai Mara National Reserve Fri-Sun. Not sure if we will have internet access there ( I hope not). Stay tuned for some final pictures/ thoughts in the near future.
Wednesday, January 19, 2011
Jan 19
Starting to wind down in preparation for our plane ride back to Nairobi and then on safari. One of the docs who is heading the DM program here may be coming to the States in June for a meeting in Washington. We did talk about her coming to Lehigh Valley Hospital and working with our Endocrine group to observe and learn about diabetes care. This would be a nice experience for all.
On a sad note, Kevin, who was pictured with Sara in an early blog (see above) died 2 days ago. He had sickle cell disease, but we are unclear of the cause of death. He was by Sara's side for the 2 weeks that she attended the hospital day care center and made him smile daily. She is, needless to say, heartbroken.
On a sad note, Kevin, who was pictured with Sara in an early blog (see above) died 2 days ago. He had sickle cell disease, but we are unclear of the cause of death. He was by Sara's side for the 2 weeks that she attended the hospital day care center and made him smile daily. She is, needless to say, heartbroken.
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| Sara and Kevin |
Tuesday, January 18, 2011
Jan 17-18th
Mon, Jan 17th- nothing exciting except for making rounds in the am. The group has swelled to over 20 since the Kenyan med students have recently joined us. Rounds are difficult in this setting. The interns speak very softly and with so many people and the wards being chaotic and the heat by mid-day (let's not get into the aromas), after 3hrs I am ready for a break.
Tues, Jan 18th- I had a meeting with the Chief of OB-GYN as well as some other docs regarding DM in pregnancy (my special interest at home). Currently no pregnant woman is screened for DM;this is done routinely in the States. In addition, there is no one here who is really well versed in the care of a diabetic who gets pregnant. So once again it is exciting that I came here at a time when these initiatives are just getting off the ground.
In the long term, it looks like I can help with patient care protocols and we will hopefully be having monthly conference calls. There are a lot of challenges; most women present for their FIRST prenatal visit at about 32 weeks and 80% deliver at home. I offered to make house calls by giraffe if they give me a cell phone and a blood glucose monitor.
The weather here remains picture perfect and the running is finally getting easier as my body gets used to the altitude. Tomorrow our whole group goes out to supper for Chinese food!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Tues, Jan 18th- I had a meeting with the Chief of OB-GYN as well as some other docs regarding DM in pregnancy (my special interest at home). Currently no pregnant woman is screened for DM;this is done routinely in the States. In addition, there is no one here who is really well versed in the care of a diabetic who gets pregnant. So once again it is exciting that I came here at a time when these initiatives are just getting off the ground.
In the long term, it looks like I can help with patient care protocols and we will hopefully be having monthly conference calls. There are a lot of challenges; most women present for their FIRST prenatal visit at about 32 weeks and 80% deliver at home. I offered to make house calls by giraffe if they give me a cell phone and a blood glucose monitor.
The weather here remains picture perfect and the running is finally getting easier as my body gets used to the altitude. Tomorrow our whole group goes out to supper for Chinese food!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Sunday, January 16, 2011
Jan15-16th Lake Baringo
x
This is probably my last e-mail. Nike has signed me up to run with the elite runners of the world to train at Iten, about 30 minutes north of Eldoret. The best of the best run here and Nike wants me to be the first male over 50 to win the Boston Marathon. They are paying me 100 Kenyan Shillings daily!!! ($1.25) and providing me with running shoes, 3 power bars a day a cold shower. By this time in April, I will be 10 lbs lighter and will drop my best marathon time from 3:17-2:02.."no worries" as they say in Kenya. With the winnings I will make my tribe in Lower Macungie the richest with many cattle and goats.
We did pass by Iten on the way to Lake Baringo which was about 3 hrs away. We stayed on an Island in the middle of the lake. It took about 15 minutes by boat to get to the island. Sara and I shared a tent which overlooked the lake. The drive to this lake was beautiful and very hilly with many winding mountain roads. It was nice a cool at the top, but in the 90s at the lake.
No swimming in the lake due to parasites and crocks (and lions and tigers and bears..oh my!). Most of the group headed for the (hopefully parasite free) pool for a day of R and R.
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| Freshwater pool overlooking lake. Marc snoring with ipod on far left (not visible) |
We had a nice barbecue which didn't start until 8 pm. It became nice and cool and we went off to bed. Unfortunately one of the residents found a poison cobra on her floor so Sara wanted our tent zipped down tightly to thwart off crocks, frogs and lions (and tigers and bears). The lack of breeze resulted in a midnight sauna and we finally opened the flaps. Crickets and birds (many varieties of birds were on the island) woke us at about 5-6 am, just in time for coffee and the sunrise.
The light lit up our tent which had a bathroom and actual hot/cold shower.
The birds enjoyed sharing our coffee, mild, sugar and ginger cookies supplied pre-breakfast...I think these birds are getting obese and diabetic from all the junk they eat.
We drove home at 10 am. The valley by the lake is very, very dry. This last picture does not look like much....
I felt empty after leaving these sites knowing that the little we gave can't last long. I assume these images fade for many when they return home. Some of us feel compelled that they don't. The work being done by those I am working with here prove the work of a few can help many.
WHOSOEVER PRESERVES A SINGLE SOUL..., SCRIPTURE ASCRIBES [MERIT] TO HIM/HER AS THOUGH THEY HAD PRESERVED A COMPLETE WORLD." Talmud,
Friday, January 14, 2011
Jan 14th- Outreach HIV clinic with Joe Mamlin
Jan 13 was pretty "quiet.." usual hospital stuff. However the Kenyan med students have started and now there are over 20 people rounding. It is very difficult to hear anything unless you are right at the bedside.
Today I have the privilege of going with Joe Mamlin to an outlying HIV clinic about 40 minutes from Eldoret. See this site if you want to see how this program has evolved with Joe's influence:
http://alumni.indiana.edu/magazine/issues/200703/kenya.shtml
Joe has taken HIV treatment to the field and his approach is comprehensive as you can see from the article above. We sent 2 pts to Moi Hospital this am, one with rheumatic heart disease in AF and another HIV with wt loss, fever and abnormal CXR- probably TB. Joe was teaching a nurse practitioner ("clinical officer") and after 4 months this CO was quite adept at handling HIV. Joe is a true internist; very good a physical exams, reading Xrays, etc.
It will be hard to forget the 14 year old girl with big brown eyes we saw today who was HIV +. She was being raised by her aunt as her mom died probably of HIV. She was started on HIV meds today and she smiled so brightly when I gave her some cookies I had with me. She also had asthma but of course the pharmacy doesn't have the proper inhalers for her.
Many of the pts we saw today would have not survived in the past since there were no outreach programs to treat HIV.
We are off Baringo Lake tomorrow and take a ferry to an island camp in the middle of the lack. Looking forward to 24 hrs of R and R.
Today I have the privilege of going with Joe Mamlin to an outlying HIV clinic about 40 minutes from Eldoret. See this site if you want to see how this program has evolved with Joe's influence:
http://alumni.indiana.edu/magazine/issues/200703/kenya.shtml
Joe has taken HIV treatment to the field and his approach is comprehensive as you can see from the article above. We sent 2 pts to Moi Hospital this am, one with rheumatic heart disease in AF and another HIV with wt loss, fever and abnormal CXR- probably TB. Joe was teaching a nurse practitioner ("clinical officer") and after 4 months this CO was quite adept at handling HIV. Joe is a true internist; very good a physical exams, reading Xrays, etc.
It will be hard to forget the 14 year old girl with big brown eyes we saw today who was HIV +. She was being raised by her aunt as her mom died probably of HIV. She was started on HIV meds today and she smiled so brightly when I gave her some cookies I had with me. She also had asthma but of course the pharmacy doesn't have the proper inhalers for her.
Many of the pts we saw today would have not survived in the past since there were no outreach programs to treat HIV.
We are off Baringo Lake tomorrow and take a ferry to an island camp in the middle of the lack. Looking forward to 24 hrs of R and R.
Wednesday, January 12, 2011
Jan 12- Kitale
Drove with the diabetes team to Kitale, about 1.5 hrs north of Eldoret. Actually it would take about 45 minutes but the road in parts were filled with potholes and we were driving off the road just to avoid driving on the road!
Kitale hospital is a district hospital ( a step "down" from Moi and similar to Webuye Hospital (see prior post). The DM program was recently started and is booming. Only 1 patient was using glucose testing despite many being on insulin. The one using a monitor is a 7 months pregnant DM2 on insulin 70/30 twice daily. She is only able to check one blood sugar a WEEK. Our pregnant pts at home check 6-8 x daily. It is quite hard to make any sensible changes. She agreed to check 1 fasting this friday and 1 pre-supper next Monday and we will call her by phone.
Another woman had high blood sugars and was diagnosed with malaria during her visit. A young 20 year old boy was just released from a 5 day hospital stay for new onset DM1 (total bill=$30). His blood sugar was over 400. When we asked him how he was injecting insulin he was completely off base and was trying to inject like we give PPDs. Like many others, he is discharged without adequate teaching. He also could not afford a glucose meter. He was one of several pts who needed large amounts of oral hydration solution because of high sugars and dehydration.
After a long day, we all went out to a Sikh restaurant for supper.
Some of you have asked about a way to donate money to a worthy charity here. The Tumaini Center was started by a group including Sonak, a Purdue faculty member who is working here full time. This center is open 4 days a week and gives homeless/street children a free meal and place to stay during the day. Some are not actually homeless, but the parents cannot afford to send them to school and make them go and beg for money. The money you give goes directly to an account which Sonak controls- no admit or other fees are taken from the donations. Knowing Sonak these few weeks, I would be assured that the money will be put directly to good use. Below are the instructions he sent me:
Kitale hospital is a district hospital ( a step "down" from Moi and similar to Webuye Hospital (see prior post). The DM program was recently started and is booming. Only 1 patient was using glucose testing despite many being on insulin. The one using a monitor is a 7 months pregnant DM2 on insulin 70/30 twice daily. She is only able to check one blood sugar a WEEK. Our pregnant pts at home check 6-8 x daily. It is quite hard to make any sensible changes. She agreed to check 1 fasting this friday and 1 pre-supper next Monday and we will call her by phone.
Another woman had high blood sugars and was diagnosed with malaria during her visit. A young 20 year old boy was just released from a 5 day hospital stay for new onset DM1 (total bill=$30). His blood sugar was over 400. When we asked him how he was injecting insulin he was completely off base and was trying to inject like we give PPDs. Like many others, he is discharged without adequate teaching. He also could not afford a glucose meter. He was one of several pts who needed large amounts of oral hydration solution because of high sugars and dehydration.
After a long day, we all went out to a Sikh restaurant for supper.
Some of you have asked about a way to donate money to a worthy charity here. The Tumaini Center was started by a group including Sonak, a Purdue faculty member who is working here full time. This center is open 4 days a week and gives homeless/street children a free meal and place to stay during the day. Some are not actually homeless, but the parents cannot afford to send them to school and make them go and beg for money. The money you give goes directly to an account which Sonak controls- no admit or other fees are taken from the donations. Knowing Sonak these few weeks, I would be assured that the money will be put directly to good use. Below are the instructions he sent me:
For tumaini center click on the following link and follow the subsequent instructions.
https://donate.purdue.edu/
CORRECTION- TRY THIS FIRST-http://www.pharmacy.purdue.
In the first drop down box (Designation Area), highlight “College of Pharmacy” (You will have to scroll down to find it).
In the second drop down box (Select a Fund), highlight “Kenya Initiative”
Then go to “Enter an amount” and insert the dollar amount of the gift you want to make.
CORRECTION- TRY THIS FIRST-http://www.pharmacy.purdue.
In the first drop down box (Designation Area), highlight “College of Pharmacy” (You will have to scroll down to find it).
In the second drop down box (Select a Fund), highlight “Kenya Initiative”
Then go to “Enter an amount” and insert the dollar amount of the gift you want to make.
Sonak Pastakia, PharmD, MPH, BCPS
Assistant Professor, Purdue University College of Pharmacy
+254 72 902 7569
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