The Mobile Clinic in Photos

Every week in the Maseno Orphan Program, Dr. Hardison and many other hospital staff do only brief rounds at the hospital in the morning and then set out to spend the day at one of five orphan program sites. While there are a lot of Hoppa Hoppas, inevitibly there are also many serious cases that people have been saving up for when the doctor comes. Every week, we end up taking people back to the hospital with us to admit them. Their stay will be covered by orphan program funds.

So this is what happens behind the scenes while I force kids to stick their feet in chemicals and the rest sit in class.

Again, these pictures are from a variety of weeks of different Saturdays.

The long line to see one of the doctors. We had several lines going in different areas depending on where the doctors got stuck based on space.

So much for patient confidentiality - the next person in line would crowd right up next to the table and chairs where the doctor and current patient were sitting, making sure not to miss out on their turn while I'm sure keeping their ears wide open. People in East Africa have no concept of personal space. None. So for them confidentiality and it being a bad thing to hang out around another person's doctor visit is an even more abstract concept. No matter how many times the frustrated Americans would ask them to back up, they would just keep closing in. The Kenyan nurses did not try very hard to keep them back either - I'm sure they thought we were being completely ridiculous.

This is the pharmacy table where nursing students and whoever else had a free hand would count out the pills prescribed by the doctors at the previous table. The doctors have a list of medications at their tables to pick from when coming up with prescriptions - the ones we get for free. The most adequate medication isn't always available, but this is certainly better than nothing.

The even longer line of people staring at the pharmacy table waiting for their perscriptions to be put into little plastic bags for them. On each bag, a picture representing a time of day would be circled (or multiple pictures as need be) to symbolize when the medicine should be taken for those who don't read. Despite trying to talk all of the patients through this, every single week people come back with horrible hypertension who ran out of their meds a week too soon even though the doctor wrote them exactly enough to get them through to the next mobile clinic. Dr. Hardison would explain through a translator until he was blue in the face but would inevitibly end up with his head in his hands out of sheer frustration. Modern medicine is hard in under-developed areas.

I kid you not that these are the medical records for this particular site. They are like college blue books that you have to take your essay tests in, only with a few more pages and cut in half. Every time the patient comes, the doctors read through the hand written notes from the previous visits and make new hand written notes. They won't treat them at the hospital unless they bring thse because this is what lets people know they are with the orphan program.

Chris and Katie, my two dear American med-student friends got to see their own patients after their first week of observing. They sat near Wanda, Frances, or Dr. Hardison in case they had any questions and to sign off on the prescriptions they decided on, but other than that they did the patient examinations on their own with their own translators. They were awesome they way they just jumped into this crazy world of tropical medicine with only one year of med school under their belts and did an amazing job of playing doctor. Here Katie is taking notes on a nine-year-old boy who was so frail and malnourished he looked like he was in pain from just breathing. He himself asked to be dewormed. They were the last patients seen on this day and showed up right at the end, so it must have taken quite a while to walk him in from wherever they came from.

And here is Chris getting his sripts checked over by Dr. Hardison before sending this lady to the pharmacy line. He was so gentle and thorough with people, it was so great to watch. He's going to be a mighty fine doctor.

Wanda, our gifted physicians assistant from Vermont was at Maseno hospital for a year while her husband worked as the business administrator for the programs with Professor Nancy.

Frances is a Kenyan doctor and the only Kenyan medical professional that I met who I have any respect for. He actually cares about the patients! I always had stickers on me, and if I wasn't around when a little one came through his line he would get up and leave to come find me to make sure that kid got a sticker (you can see it on this little boy's hand). He would great me every day with a "Kali, are you feeling kali today?" taking the Swahili definiton of my name (fierce), and thinking it was hysterical.


Wanda with Newton (like Sir Isaac, as he likes to tell people) and Chris, two med students at Maseno University who give up their Saturdays every single week to help as translators for the American medical folks as they meet with patients. And sitting for five hours straight telling Dr. Hardison that this old lady, as the last one, has pain here, here, here... it's not always that fun. They are just all around great guys. For the record, these guys were also the only ones in Kenya who never hit on me. Ever. And I love them dearly for it.