Tuesday, June 7, 2011

Back By Popular Demand Following Technical Difficulties!

So, when I told everyone I'd have regular internet here, I may have been lying. THe internet has been pretty sporadic, so I have used that as an excuse to ignore the blog.
So - a quick update!
Last week I started out on the peds wards, switching from adult medicine. There is a lot I could say about that - initially was a very tough transition, mostly due to some very sick kids (by Kenyan OR US standards). However, things have settled down a little this week, fortunately.
Last Friday I also had the opportunity to travel to the AMPATH clinic in Turbo, a nearby village with Dr. Mamlin. I sat in with the clinical officer seeing patients, and it was a good experience seeing how AMPATH is transitioning from providing HIV care to providing primary care for thousands of patients here in Western Kenya. There are still a lot of challenges, but I'm optimistic that it's actually working! As anyone who has been here before knows, it's hard to spend any amount of time with Dr. Mamlin and not be inspired.

While at Turbo I was able to sit in on an initial visit, which was an interesting experience. A young man and his wife came to the clinic after he tested positive for HIV the previous day while being treated for malaria. Once he tested positive, his wife was also tested and her test was negative. You could feel their anxiety in the room. The husband's only question after the history and physical was "So, I am now positive for the virus, pbut my wife is negative. What do we do now to keep her and our children safe?" The young man was enrolled in the AMPATH program and had an initial laboratory evalutation, and we gave him medicine for oral thrush. Sagita, the clinical officier, counselled this man and his wife on safe sex practices and discussed what it means to be a discordant couple. He will come back in a couple of weeks for follow up to see what his CD4 count is and to determine if he needs antiretroviral medications. However, by the end of the visit, though obviously still reeling from this diagnosis, they seemed to leave with a sense of hope.

Sagita, the C.O and Lillian, a mental health practioner

Rose, the cook in her kitchen

One of the clinic workers demonstrating how to eat ugali

At Turbo I was also graded on my ugali-eating skills. Ugali is the local staple - made of boiled corn flour. I've described it before as having the texture of polenta but the consistency of playdoh. Regardless, I think it's delicious! This ugali, cooked by a woman named Rose was some of the best I'd ever had! I was given a ridiculously large hunk of ugali, along with some kale and meat, and managed to eat all of it, and so scored an "A." I was pretty proud of myself for that.

After Turbo we spent the weekend in beautiful Lake Bogoria, in a tent that could only be described as "princess camping" The tent itself had an attached bathroom (score of 10/10) and beds, as well as a balcony from which you could watch the sunset. It was a nice weekend of relaxing, birdwatching and hippo spotting.

Princess camping tent, complete with bed and freestanding wardrobe!

Sorry for the long delay - hopefully the next post will be sooner!

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