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17th January 2006

The Keyna Experience: The Early Days

posted in Uncategorized |

(copied from email. It’s easier that way)

Hi everybody!

Well, I made it safe and sound to Africa, with only a mild (ha!) case of air sickness to spoil the trip. Of course, I forgot quite a few essentials—medical tools (I really could use my reflex hammer. And my pin light), medical books, gloves, a watch and the Wireless Access Card for the 15 pounds laptop that I lugged all over 4 international airports. So now, I have a computer and no way to hook it up to the internet — the precise reason that I brought it. Luckily, there are some (albeit incredibly slow) desktops provided here, I just have to compete for them. It’s not going to make match day fun (but that whole experience is just not fun period), but I guess I’ll figure it out. And when Rachel’s husband comes in ten or so days, he’s willing to bring the card. So, Karin, if you could look in the green computer bag and see if there happens to be a small card, I’d greatly appreciate it. If not, dad, the computer’s a Compaq Presario 2100. I have no idea how old it is. If there’s more information that you need to see if you have a card that works, let me know.

So I’m typing this out on the internet-less computer, with the hopes to transfer it to the desktop (I did remember to bring my memory stick! Yay for me!), and as it takes a while, I’m making this a group email to everybody. I promise individual emails soon — especially if I get emails back (hint, hint).

It’s hard to believe that I’m halfway across the country. Actually, it’s not. There are some very obvious differences — the first being that it’s probably 70 degrees and sunny and there’s blossoms on all of the trees!

We arrived in Nairobi on Saturday night and all except for our attending’s, luggage managed to make it with us (not to worry, his came the next morning). We spent the night in a very posh hotel — except for the fact that the beds were very hard and the power flickered (while I was 7 stories up in the air, trapped in the elevator, I might add) and the place had 13 feet gates around it with guards, and the ZEBRAS in the field across from the hotel, one might have thought Dorothy was still in Kansas.

We spent most of the day in Nairobi, seeing all of the tourist sites. We went to an animal orphanage that rescues baby animals and protects them until they are able to be released in the wild, and watched them feed and bathe baby elephants. The cutest was the 3 month old, who was thoroughly petted by everyone – it was hard resisting the idea of sneaking it into my luggage, but I don’t think he would have fit. We then went to the Giraffe Center, and it was there that I kissed a giraffe, Daisy. I have pictures to prove it! Giraffes have the longest roughest tongues in the world, but their pretty eyes and long eyelashes are enough to win anybody over. It was really fun. I managed to stay mostly in the shade, but the Kenya sun is very strong and I’m already sunburned. I have learned my lesson and salve sunscreen on 2-3 times a day. I think I’ll still come back redder than before.

We visited the Karen Blixen home (she’s the author who wrote Out of Africa—I really don’t know that much about her. The price to see the inside of her house was way too much, so we ended up just walking around the gardens) and then flew up to Eldoret in a very small (I think if we all thought very skinny thoughts, it might have held 12 people), propeller plane. The residents are now threatening to dose me up on Valium for the return trip, so you can guess how I enjoyed the trip–I’ve never been so relieved for solid ground in my entire life.

Eldoret is a smaller town, up north on the Rift Valley, about 50 miles north of the equator. The president is from Eldoret; hence the reason that there’s a medical college here. I’m staying in the IU (Indiana University) House, which for the first few days was the major source of confusion and stressed. Our first day here (when I was sick and not so happy), Rachel and I were informed that we’d be moving over the student hostel in a couple of days—something that we were not expecting and had, in fact, paid to stay in the House. We’ve sorted things out now, with much complaining and explaining and I’ll be staying here. 🙂 I’m very relieved. The main reason for wanting me in the student hostels was that “I wouldn’t get the full experience that the Kenyan medical students get,” but the residents and attendings aren’t getting the full Kenyan experience staying here either, so I’m willing to forgo that. And thank you, but I’d rather not come down with parasites and horribly crampy diarrhea because there isn’t any clean water to drink.

I started working in the hospital yesterday. It wasn’t as bad as I expected. The poverty here is much like what I saw in Guatemala, and frankly, the public hospital that we visited in Antigua, where the chronically mentally ill were kept, was one of the most depressing sights I’ve ever witnessed and 20 times worse than the conditions here. Here, while there’s a certain odor, it’s not overwhelming and the patients at least seem to have their dignity. There’s often 2 people to a bed—and often it is an immunosuppressed (aka AIDS patient) lying next to a patient with active tuberculosis. Already, in my couple of days here, I’ve encountered diseases that I’ve never even heard of back home. It’s crazy stuff. The best part is that so much of it is neurology! We have so many patients with stroke, Guillain-Barre syndrome, cranial nerve paralysis, bilateral LE weakness that might be due to severe mitral reguritation and emboli — a lot from unknown causes that really is stretching my mind. I already have dozens of diseases that I need to be reading up on. The old saying about “hoofbeats” doesn’t exactly apply here both literally and figuratively! While some of the doctors back in the state had difficulty understanding wh somebody would want to be competently trained in both subjects, it’s not hard to see how closely related medicine and neurology is here — and there are few (ie no) neurology doctors here. A fourth year neuro resident just arrived yesterday and I’m really excited to be working with her–and the rest of the doctors here are practically salivating at the thought of getting someone who might know what’s going on.

I’ll be working with one of the women’s medicine teams (there’s 2 women’s teams and 2 men’s teams), and am easing my way in, but it should be a good experience. There’re a lot of changes in how the medical system works here and a lot of challenges to overcome. Many of the patients never receive a diagnosis, because the tests cost too much money or aren’t available. And as a medical student, it’s hard determining what my role and responsibilities are–it’s hard to see that I’m making any kind of contribution at all. The teams are huge. We’ve had a Consultant both mornings (the equivalent of an attending) which is unusual—usually, they only round a couple of days a week. Then there’s a Registrar (a resident), an intern who really completely run the team when the consultant isn’t there, Clinical Officers (like Nurse Practitioners), CO students, 4 medical students, a social worker, and a nurse. Add to that myself, and the couple of US residents and it’s a pack–today it was 24 people around one single twin bed. I’ve had difficulty hearing everything going on and I’ve yet to lay a stethoscope on anyone. However, I think a good part of the confusion is because they’re just starting a new year here. We have brand new interns and medical students, and so, hopefully as it settles down, things will improve. But the Consultants and residents that I’ve worked with have been incredibly informative and I’ve learned a lot and am really enjoying it.

There’re 6 of us from Utah on the trip right now. Rachel, the other med student, Karla and Leigh Anna the two residents, Dr. Granger and his 12-year old grandson, Dion, who is determined to be as independent as possible, and will probably end up giving his grandfather ulcers by the end of the trip. It’s been a lot of fun traveling with them and working with them. And the rest of the residents and students from all over the country (Indiana, Purdue, Brown, U Wash) are wonderful people. We’re planning some safaris as a group over the weekends so I’ll get to see a lot of the sights and animals of Kenya. It’s not quite as inexpensive here in Kenya as one would think—or rather, some things, like accommodations and transportation for trips are quite costly, but other things like food and soda is incredibly cheap—only a few cents. So I guess it’ll all work out in the end, but Karin, I need you to keep an eye out for a check from the University and to deposit it for me. Actually, if you could look through all of my mail and email me the contents, I’d be grateful. Hopefully, you got my other email/page about Match stuff as well, because things might become pretty desperate if I don’t figure that out.

I did walk down into the city center of Eldoret yesterday. It’s a bustling place and one has to watch very closely to avoid being mowed over by the trucks and cars and the wandering donkeys (which have a black stripe down their back that makes them look like relatives of zebras). Eldoret, thankfully, is not a touristy as much of the rest of the country, so we aren’t bombarded by peddlers. I hope to be able to get a wristwatch—not being able to tell time is becoming quite the pain. I did figure out that my little iPod has an alarm in it, so I’m waking up to music.

With my laptop not connected, I’m not going to be able to communicate by IM as I had hoped–I can’t hog the computers like that. I can get mail here, however it takes at least 14-21 days to get anything and it can be very unreliable. But my address is:
Julia Durrant
c/o Indiana Team
Moi University College of Health Sciences
P.O. Box 4606
Eldoret, Kenya

Telephone here is 011-254-53-61222. There’s a rumor that I’ll be getting a Kenyan cell phone where I can put prepaid minutes on to call home, but it’s still very expensive (and three days later, still a rumor). Email’s still the best way to talk to me and I want you to talk to me! My yahoo account seems to work the fastest (it’s all painfully slow), so entertain me with stories about what’s going on. And feel free to forward to anybody that I missed as well.

I miss you all and think about you often. You’re all in my thoughts and prayers. Have fun and keep me involved in your lives, so I don’t feel quite so separated.

Love to all,

Julia

This entry was posted on Tuesday, January 17th, 2006 at 5:14 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.

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