A Sad Situation
I am back in Mombasa after a week in the bush. My friends from the US have arrived, so I am spending a little time here, although I will be returning to the bush shortly for a short time.
I had a sad case this week. One morning, right after arriving in the clinic, a woman came in holding a little baby. At first I thought the baby was dead, it looked lifeless. Then it took a gasping breath, and moved a little. So, we busily started doing what we could to revive the child. The unfortunate thing is that we couldn't do much: we didn't have any medications to work with. We gave an injection of penicillin, as the lungs sounded terrible and we suspected severe pneumonia. We didn't have any medications to give to improve the child's breathing, medications that would have been standard in the US. We'd had some earlier, some epi, but we'd run out the week before and hadn't the money to get more. So, the baby was having agonal breathing, the rate maybe 8 times a minute, and needed oxygen, only there is no oxygen. There were some old tanks that were donated a long time ago, but of course were empty. We tried using an ambubag, with no O2, but we only had an adult mask, not a pediatric, so that was unsuccessful. Finally, we decided that we couldn't treat the child, and referred them to a clinic more than fifteen minutes on a terrible road away. The woman had no money, so we gave her the money to pay for a matatu to go to the other clinic. These matatus are minivans used as taxis, packed full with as many as 15 people. So we sent a critically ill child, who needed to be emergently intubated, away in a a matatu--a slow bumpy taxi.
I have to say, I have felt useless at work from time to time, when I didn't feel that I was contributing. But I have never felt completely helpless, unable to do anything, overwhelmingly helpless. This was how I felt then. As I watched the lady get in the matatu, I'm thinking that I should be going with her, to give the baby mouth to mouth, but then for what? When she gets to the clinic, she has no money, so they won't treat the baby anyhow, assuming that the baby survives the ride there. I just stood there like some survivor from a jet crash, stunned, and people around me went on like it was normal. Turns out it is. They see this type of thing more often than I can comfortably imagine. There are patients who die here from simple, easily treated problems because there isn't the money to buy proper medications.
So, I knew that this was out here. I knew that this happened in places around the world. I guess I just got introduced to it. And it didn't leave me feeling very good. I was looking around for someone, something to direct my anger at. There is a community committee who runs this clinic, and they are inefficient, uneducated, and likely corrupt. The doctor had to loan the clinic 5000 shillings, which is nearly half a month's pay for him, to buy essential meds. Am I to be angry at the committee? Should I be angry at myself, could I have done more? After all, what good am I here if I can't do anything? But in the end, there was just this dark submission to the reality that this happens. It doesn't happen at Duke Hospital, this child would have been easily treated, but it happens here at Kokotoni Clinic.
Being in Kenya opens up a whole new reality, where the people running this nation are terribly corrupt, and the rest of the country suffers. I have had conversations with several people, where I ask why they as a people tolerate their governments blatantly stealing money from them, and when they are caught getting away scotfree. (An example, you can go to jail for a decade for stealing a cow, but steal a million shillings and you will only get a few months--they want the money to come back into circulation). These people reply that they have no rights, that the police are as corrupt if not more than the government so protests aren't possible, and that nothing can be done by the little man, because power and money really do speak here. So it continues, this corruption, this inefficiency, and hence this poverty. Not that I have a solution, but it certainly raises my appreciation for my home nation.
Anyhow, it's not been bad here, I just had a sad experience. There are a lot of shocks to be had here, a lot of eye-opening events. This is a different world, really, and I am frequently reminded of that. For example, I was talking with the doctor's (unemployed) brother, and was commenting that a good thing about Kenya is that with a little money, one call live a decent life. But he, who is a sharp fellow, told me that even something cheap, a bag of rice for 20 shillings, is only cheap if you have the 20 shillings. If you have nothing, then even a bag of rice is expensive. And that is the way to learn to view the world from a totally different perception, from a person who hasn't the 20 shillings.
Anyhow, I will be returning to Kokotoni on Tuesday, and back to Mombasa on Friday to catch a ride to Malindi, a place up north I haven't yet visited. I have made good friends at the clinic, they call me now when I am in Mombasa, and I think they miss me. I miss them too, they've made my stay there very nice. They treat me as a guest, and something special, or interesting that happens in their lives. So, it is a good time there.
Until later, keep safe.
