Dreams

I find that lately I have been dreaming a lot. Now that I've been at the clinic for a few months I'm feeling a little more settled into my role there. It is amazing the difference that this little community clinic is making. We are well on our way to becoming a medical center. The number of patients continues to increase each year. We are also in the process of expanding our services. By the end of the year we should have a dental office and optometry in addition to our "usual" medical services. We are also hoping to move our home based care team (Tumaini na Afya) over to work out of the same location.

What is amazing to me is that up until this week we have been functioning with two Kenyan RN's, myself, a dental tech (who comes once a week) and a pharmacy student doing an internship. Often the flow of patients is so massive that it is hard to think about preventative health care. But lately I've been dreaming of ways we can improve the quality of health care we provide.

As of today we have two new staff members joining us. One is a Clinical Officer (very much like a PA) and the other is a lab technician. In the last few weeks the other nurses and myself have been talking about what a difference it will make to have a few extra pairs of hands.

So what am I dreaming of? A whole lot! Here it is:

1. Typhoid Immunization. It is crazy to me that if an American plans to travel to Kenya he or she must first be vaccinated against typhoid; but the Kenyans who live here don't even know that there is a vaccine against typhoid! The cost of vaccination is just under $5 per person. But treatment of typhoid runs around $320 if you have a bad case. My hope is to at some point this year hold a month long Anti-Typhoid campaign. I would love to have one day where we go to a public location and offer the vaccine to everyone in the community. Right now I'm doing the research to see what it is going to take to make this dream a reality.
2. Well Children's Clinic. We currently hold an immunization clinic on Tues and Thurs every week. The mama's bring their babies to get poked and weighed. And then that is the end of it. Honestly up to this point I don't see how any more could have been done. There just hasn't been the manpower around to pull it off. But I would love to actually do physical and developmental assessments on all of the children. If diseases and disorders are picked up early and life there is so much more that can be done about them. Often even to the point of saving lives.
3. Women's Clinic. We currently provide prenatal care and that is the extent of our women's health program. Did you know that cervical cancer is one of the easiest cancers to treat with a very high curative rate? But if women are never tested for it how can they be treated? When one considers that many women in this area have HIV and that cervical cancer is a lot more common than HIV one can see that the need for screening and treatment is huge. For this one to happen I would need to get some further training and equipment. But nonetheless this remains a big dream of mine that I hope to one day see become a reality! When I spoke with our new clinical officer briefly last week she expressed that she also has interest in women's health care.
4. Hypertension Screening and Treatment. Hypertension (HTN) or high blood pressure is a big problem here. Unfortunately because patients with HTN don't feel sick it often doesn't get picked up. There isn't much understanding of the damage that HTN can do to the entire body. When clients are treated they often get a one or two week prescription and then that is the end of the story. I'd love to start screening for and treating this disease.
5. First Aid Many of our patients travel quite a distance to get to us. Often if some basic first aid could be performed before arriving at the clinic it would make a drastic difference in the patient's overall outcome. Simple things like applying pressure to a bleeding wound need to be taught. I'd love to develop a one day course in basic first aid. We could start be offering it to the Empowering Lives Staff and then offer it to a broader audience.

So there you have it! Some of my dreams for medical work in this community. I'm learning so much in my daily practice in the clinic. This truly is FAMILY practice. We do everything from delivering babies, to treating illness and injury, to managing chronic illness in the elderly! You never know what will walk through the door next. I'm loving the fact that I am living my dream of providing medical care in rural Africa!