Saturday, July 30, 2011

The Project Begins

In Africa, people wait. I know, I know, in America we wait too. You stand in line at a restaurant or the post office for fifteen minutes and you feel you're wasting your time. But in Africa people sit or stand waiting for hours. Women settle onto the ground by the road with their baskets of avocados, or charcoal, or oranges, or bananas, or bottles of water, or whatever else they've gathered for sale, and wait all day hoping to sell three or four so they can afford to feed their family. Men on motorcycles gather at the corner waiting for hours hoping someone will give them 50 cents for a ride across town. Young men and women sit by the road under a tree all day just staring ... for they have nothing else to do.

At Keumbu Hospital the people coming to talk to the doctor start filing in after sunrise, say sevenish, and continue accumulating on the benches in front of our out-patient clinic until we finally start seeing them after morning rounds, so usually about noon. Those who are admitted sit in bed all day for a few minutes of our exam and almost no explanation of what we're doing to them or how long they'll be here. Well ... I suppose it's not that different from America after all.

I asked my friend, Pastor, how was the Kenyan economy? He said "In the ICU. Unemployment is sky high, inflation is worse, and the future is bleak." When I arrived my dollar bought 84 Kenyan Shillings, (Ksh). Today, ten days later, it's getting 88.3. There are banks everywhere, but lines of credit are extremely difficult, a point I bring out because of my building problems.

I brought $5000 cash with me. $2000 of that was for the project and the rest for travel expenses. I had planned on spending $5000 on the project, $2500 I raised as donations, and $2500 of my own money, but I didn't feel comfortable carrying $8000 in cash around -- I was nervous even with the $5000, but I've had no problems. In any case, Zachery, the water engineer here in Keumbu, priced out the project for me. The first $1000 went to the necessities; cleaning the storage tank, equipment for the pump and basic plumbing, and labor (which is incredibly cheap). The next $3000 was going to replacing the existing leaky and rusty gutter system which is to be our source of water into the cistern (rain water coming off the roofs of the hospital). Before went to the supply house, I asked Zachery if I'd be able to use my credit card and he assured me I could. When I arrived at the plumbing supply store I asked if I could use my credit card and he also said I could. So we spent about two hours developing our order and everything fell into place, falling within the budget at $3500. I handed him my Mastercard and he wrote up the order and handed it to me, telling me he was worried about the dollar/shilling conversion and requested I take it to his bank and they'd make it a direct deposit. So off Zachery and I went to the bank. The bank couldn't take it. I called my Mastercard people and they assured me it would be no problem for the merchant to run the card, so back we went to the hardware store. I had the Mastercard people on the phone, long distance from Kenya to America, and handed him the phone, and they assured him it would be no problem, all he had to do was run the card and he'd get his 311,000 shillings. But no. It turned out he had never run a credit card purchase in his life, and never could and never would. By the end of the afternoon there were three other banks involved and still no money. I converted all the cash I could spare into shillings and paid off what I could. We'll have the water project finished, but it won't be as extensive as planned. Few new gutters. But, still, we WILL have running water into the hospital for the first time in its twelve year existence, and that will be an accomplishment.

Next blog: Nakuru Lake, the flamingo capital of the world!

Thursday, July 28, 2011

Return to Keumbu Hospital

It's been eleven months since last I arrived at the Level III regional hospital here in Keumubu Kenya. It's always wonderful to see friends again, and meet new faces. In this place, in particular, where the needs are so great, my presence and presents brought many smiles. For the wards I brought eight basic stethoscopes, and a nicer one for the head doctor. The Matron, in charge of maternity, received seven handmade caps to give to the babies she delivers (Thank you Jan Bold). I photographed one placed on the scalp of a baby delivered shortly after my arrival. For the pharmacist I brought a bottle of acetaminophen (Tylenol), a drug not available here. I brought two blood pressure machines; the staff delighted in testing out the digital one. Also I gave an electronic thermometer.

They took me on a tour of the hospital changes. Primarily they've two projects, an x-ray room and refurbishing the surgical theatre. On my last visit they had no x-ray capability, so anyone with lung problems with concern for TB or pneumonia or cancer, or those with possible broken bones, had to be sent to the level V hospital in Kisii if an x-ray was needed. Now they finally have a machine (not sure who donated it, or even if it works), and they're currently constructing a building around the machine to house it. They decided to build at the entrance to the parking lot hallway, which will give good access, but blocked off the ambulance that parks in that hallway. When I pointed this out, that now the ambulance would be a permanent fixture in the hallway they said not to worry, it didn't run anyway. The surgical theatre was getting a makeover with fresh paint. The hospital administrator and all the other officials posed in the one room empty surgical suite for me to take photos (I'll send photos when I have better email access, or failing this, when I return to USA). They are very hopeful of having a surgeon someday soon, whatever that means.

As you know, my main goal on this trip is the water project. The hospital has no water, relying on carrying buckets into the hospital for the occasional use (such as cooking for the inpatients and laundry) from collected rainwater. The hospital was built with plumbing, but no source of water. So the project now has several aspects. First off is refurbishing the thousand liter holding tank. It's a giant cistern which initially had all the rain water that ran off the roofs into the gutters into the tanks. However, since they had no way to get the water out of the cistern, they rerouted the gutters to large water collecting tanks on the surface, which is where they currently get what little they have. Since the tank has never been used it will need to be refurbished, cleaned, the cracks cemented, etc. The next step is to reroute the gutters into the cistern, a minor issue. Third is to build the pump/motor/plumbing system to bring the water from the cistern to the existing plumbing structure. Fourth will be to route electricity to the pump/motor. This is not a minor problem, since electricity is variable and sometimes must run off an inadequate generator. Fifth is to refurbish the plumbing in the hospital as needed. Sixth is to supply a purifier in the system so the water can be consumed (it is useable for washing hands and laundry without one). Step seven is to fix the gutter system, which is old and leaks badly. Eighth will be to dig a well for when the rain isn't sufficient. I have $3000 in donations to work with initially, and am willing to put a couple of thousand of my own money into the system. This morning I met with the water engineer, a capable man who teaches engineering at the university. We went over the needs and he will develop an itemized budget to present to me tomorrow. So next blog should report how many of these steps we can afford.

I was supposed to have a purifier sent from USA. I had a contract and paid $2600 for the machine from Aqua Sun, with the understanding that it would be delivered to UPS at the Nairobi airport by the 26th July. When I went to that office, they searched but could find no record of it having been shipped. That evening I called the Aqua Sun office and found out it had never been shipped, that they had been out of stock of the UV lights, but were ready to ship it now. I told them to cancel, I couldn't arrange for the transfer to Kesumu if I wasn't there and this seemed too unreliable. So, the water engineer here will have to search for a local purifier, which probably is what I should have done in the first place.

Laundry is currently done by hand. They have a small washing machine in the laundry room, but it is broken. They bring rain water into a big tub and hand wash the sheets and hang them on the outside lines to dry.

I went on rounds at the hospital this morning. Only three children in the pediatric ward today, all with malaria. The youngest, about 18 months, presented yesterday with fever, vomiting, bronchospasm, and convulsions. She's much improved after 24 hours of IV Quinine therapy. In the woman's ward I examined a case of submandibular abscess requiring emergency drainage, a couple of cases typhoid fever, and a woman with vaginal bleeding whose uterus was tender and enlarged to 10 week size. In the men's ward there was a fellow recovering from malaria, another man dying of metastatic esophageal cancer, and a fellow who had been under treatment for 2 weeks, had been discharged the day before, but couldn't afford to pay his hospital bill so was kept prisoner in the ward until he could come up with the money (at a rate of $1.75 US a day). I asked the head doctor how long they would keep him if he never came up with the money and she said most patients wandered off after a couple of weeks. Another man was admitted with stomach pains the day before. I questioned him and examined him and determined he had a classic case of PUD, peptic ulcer disease. He mostly had pain after he ate, and his tenderness was well localized to the pit of his stomach area. I suggested they treat him with Pepcid, and stop the Rocephin and Flagyl they'd been using. They agreed to stop the Rocephin, and to add the Pepcid, but would continue the antibiotic Flagyl, which they consider appropriate treatment for ulcers. This is probably based on prior misdiagnosis in the past, so ... it's a practice that will continue.

This weekend Angela and I plan to head for Lake Nakuru, the national park famous for being home of 10,000 flamingos. This is the height of tourist season, it turns out, so there are no accommodations. Fortunately, Angela has friends (and cousins) everywhere and promises we'll find a place.

Tuesday, July 26, 2011

Back to Nairobi

This Kenyan missionary trip was planned for three stages. The first four days were vacation, lovely days on the beach. They've been fabulous, with camel rides, a tour of a fifteenth century Portuguese fort, a tromp through a natural wildlife park where we fed the giraffes and fended off large tribes of monkeys, jet skis, and a colorful glass bottom boat tour out to the coral reefs which included snorkeling. I've snorkeled in the Red Sea, the Caribbean, Hawaii, Isla Mujeres (Mexico) and now the Indian Ocean.

We returned to Nairobi with plans to pick up the Purifier being shipped from Nevada. However, the fellow who was responsible for shipping it never sent the tracking number, even with email request reminders. UPS here searched all their records and could find no indication it was ever shipped (was supposed to be shipped on the 18th). Next I'll call him long distance (!!!) and see if I can find out what happened. Meanwhile, we're spending an extra unplanned night in Nairobi.

At lunch at Pizza Hut (really!) today I sat with a group of Canadian college students. As part of their education they are taking an extended program here doing missionary work. There were four of them, two of each gender, aged 20 or so. Very delighted and inspired by the volunteer work they've done here. One was a physical therapist in training who has been working with disabled children in an orphanage. They're all doing fascinating work. I asked how long they'd been here ... so far three months. THREE MONTHS! They're finishing up their assignments now and will be traveling to other parts of Africa on tour, from here to Rwanda. Last year while here I met many young (and some older) American volunteers. They travel without fear and are learning so much and giving of themselves, helping so many. It's truly a blessing, or, as we say in Hebrew, a mitzvah.

I've taken a bout 250 photos thus far. I put together six of them with an article about Fort Jesus and sent it to my Sun Herald contact, Anita Lee, though I don't know if she'll want to publish it. I've done a tiny bit of writing on my novel, keeping a diary, and written a bit of other fiction. Already running low on money and clean laundry.

Saturday, July 23, 2011

Traveling across the globe gives perspective on both the immensity of our planet, and man's success at conquering the difficulties of traversing such distances. I left Gulfport at noon, a quick jump to Atlanta, on to Rome, and then to Nairobi. Each stop had a 2 hour planned wait, and each time the plane was an hour and a half leaving, so the transitions worked out fine. I was met at the airport by Angela, my escort for the trip. Angela, My Angel, is the head physician at my hospital in the small town of Keumbu. She took a three week leave to accompany on this trip.

All large cities are dangerous; by the very nature of bringing masses of people together, many must live in poverty and survive using desperate measures. The larger the city (and the poorer the host country), the more dangers there are in the wrong areas. As such, in a city such as Nairobi it's important to stay in a "safe" hotel, in my case, the Nairobi Intercontinental. Angela's cousin is the chief Consier at the hotel, another cousin is in charge of the outdoor bar, and a third manages the hotel parking. As such, we had excellent service. It's expensive to stay in these big city hotels, $400 a night, with the breakfast buffet at $20, but, you know, it's part of travel. Once I get to Keumbu living expense will be considerably cheaper.

In the morning we traveled to Mombasa, the resort city on Kenya's North Beach. The North Beach sits on a lagoon, very shallow waters out to a coral reef, where we took a glass bottom boat tour and enjoyed an afternoon of snorkeling. We also have enjoyed the other amenities of the beach town, including camel rides on the beach and fabulous meals. Later today we'll tour a national forest.

Tuesday we return to Nairobi to pick up the Purifier being sent from Nevada, arrange for its transport to Keumbu, and on to the hospital there to undertake the water project (and to consult on the patient care). I know the water will be very helpful. My medical expertise, on the other hand, might not be. They have a system that works, running the masses through the clinics, using the medications and techniques they're used to. I have a suitcase jammed with medical equipment and medication to donate, and those will be appreciated.

Tuesday, July 19, 2011

Leaving for Africa

Tomorrow I return to Africa; Gulfport to Atlanta to Rome to Nairobi. At the UPS center at the airport in Nairobi I’ll pick up the purifier being sent from Nevada by Aqua-Sun. The purifier is the key element to my water project, purchased with funds from the Rotary Club and other volunteer donations. I’ll somehow arrange to get the eighty-pound purifier and my own luggage on a bus for the six-hour trip to Keumbu. If you want to find Keumbu on Google … well, good luck. I actually did find Google World photos of the village by tracing back along the road from Kisii, a 45 minute bus ride away.

I’ll be at the Keumbu hospital for ten days overseeing the water project. Last year if we wanted water in the hospital we had to bring it over by bucket from the rain-collecting storage tanks. Very little hand washing occurred. The project is to install a pump to bring the water from the storage tanks, through the purifier, and to the hospital’s plumbing. Yes, the hospital has plumbing. It was installed when built, but never supplied with water. I understand the personnel and plans are ready to go when I arrive in Keumbu. Everyone’s just waiting on me to arrive with the purifier and the money for the materials.

Besides the water project, I’ll be helping out in the hospital. Last year I diagnosed a slew of tropical diseases, including leprosy and Typhus, and studied the scourge of Malaria. I heard the government finally assigned an actual doctor to the hospital, so I’m eager to meet him. It’ll be good to see my many friends there, including the pharmacist for whom I’m bringing a box of valued Tylenol. My suitcase includes donated and purchased medical items; including two blood pressure machines and about a dozen stethoscopes, equipment unavailable there last year. They worked with so little, it amazed me to see how many they helped.

While I’m in Keumbu I’ll have the opportunity to visit the boy I’m sponsoring for prep school. His father, the Pastor, welcomed me as an honored guest during my stay last year. Once back in the states, I wired them money to have electricity connected to the Pastor’s mud house, and extended to the dorm where he houses the nine orphan girls he’s adopted. It’ll be interesting to see what uses he’s found for electricity. Will we still have to pump our own water? Will there be refrigeration, or will we still take our milk and our eggs straight from the animals? Will the old computer he had found somewhere actually function?

The trip won’t be all work. When I first arrive I’ll spend four days with my lady friend at one of Kenya’s famed North Beach Resorts. We’ve been writing each other all year, so this will be quite the joyful reunion. On the tail end of the trip I’m taking safari again. It’s an experience well worth repeating; seeing the animals up close in their natural habitat can’t help but inspire another book.

When I tell people I’m going to Africa they often inquire about the heat. Kenya is on the equator, my hospital in the mountains. Its weather is like Hawaii’s; always temperate. So while you’re huddling in air conditioning, I’ll be sunning on the Indian Ocean beach with Angela. See you in August!

Wednesday, July 13, 2011

Ndovu the Elephant finds his way home

When you arrive at a restaurant and ask how long the wait will be, they always exaggerate. "Thirty minutes, Dear. You want to wait?" So you saddle up to the bar and you're hardly halfway through your wine when your disco call box vibrates, giving you a little thrill if you stuck it in your pants. Checking your watch, you see it's only been twenty minutes, and "Wow, isn't that great? Sooner than they said!"

So I'm having the same deal with my book publisher. The first box of 60 books arrived via air shipment. They're lovely! But what about the other couple of thousand plus? The Korean shipper claims they'll arrive on the eighth, in plenty of time for the August 20th book signing (3-6pm Negrotto's in Biloxi). But the local agent is my maitre d', and SHE says the 17th ... cutting it a little too close. So I forked up another $500+ for another 200 by air, "just in case."

Well, it does go to show I'll have books for the signing, so y'all come. Ndovu is a cutie!

Sunday, July 10, 2011

Ndovu the Elephant - Lost in Korea.

I’ve put together another children’s photo book based on safari photos taken last year in Kenya. It’s called “Ndovu the Elephant – an African Tale.” 36 photos of animals in their natural habitat with a cute story about a baby elephant lost on the Serengeti looking for his family. I contracted with a company in Korea to do the printing and planned a big book debut for August 20. I kept asking my agent since March “Are you CERTAIN this will be ready on time,” and she assured me there would be no problem.

So I planned the big debut including sending out 1500 postcard invitations. The agent said the books would be in my hand by the end of July which meant they would arrive in Gulfport while I was in Africa. What could possibly go wrong with this plan? Even when the date was pushed back to August 6th I was sure everything would be okay.

On July 8th she wrote me saying there were further delays and probably wouldn’t be able to deliver the books until August 17th. OMG! I’m going to have three or four hundred people coming to a book signing and not have any books! What a disaster! For $700 more I can have them air ship me 250 copies. What choice do I have? Thank God I don’t make my living this way.

"Ndovu the Elephant -- An African Tale" www.NdovutheElephant.com

$20 + $5 shipping, personalized autograph.