leaning now into the breeze

thoughts, part II.

that there have been 12 confirmed cases of polio this month in kenya alone, and one confirmed death of a child who succumbed to polio. what? how can we live so comfortably in our country because a disease has been eradicated, yet not even all the way over on the other side of the world, children have died from it. now. in 2013. this is what upsets me, seeing the absolute injustice of healthcare across the world.

I will never get sick of driving down a highway and casually passing a herd of zebras. it’s magical.

the longer I’m in kenya, the more I’m convinced its just melbourne but further away. the weather here is ridiculous. I’m changing outfits more than twice a day because its freezing of a morning, the sun comes out and I start sweating balls, then the afternoon may bring a thunderstorm and then we get tropical. hardly feels like I’ve left home at all.

I went to church last sunday (which was incredible in its own right and will probably get its own post) but the term “sunday best” is very true here. people might wear their rags during the week, but they have the most incredible and colourful outfits they wear to church. it’s pretty awesome. I still believe that god doesn’t care what you wear, but it’s a matter of pride here, which I love. kenyans are full of pride and aren’t afraid to express it. maybe that’s why I love it here, because I’m so proud to be australian and I love people who are proud of where they come from & don’t try to hide it.

I’ve had more marriage proposals in kenya than I can count. I was counting in my first month but stopped when I could no longer keep track. having men hit on me in australia is a rare event, in fact I wouldn’t even be able to recognise if they were, it happens that infrequently. but here, it’s at least a daily occurance. I was walking home the other day and had a man call out “hey sister, you are very sexy” and I actually laughed out loud. kenyan men put themselves out there, which I have to give them credit for. I do have a bad habit of laughing always at the wrong times, and now that can be extended to when I’m being hit on.

communication is so important in a country like kenya. even in the slums, you’ll find the poorest of people with a mobile phone. I was shocked, initially, thinking that how could they justify having a mobile phone when they can hardly afford any other basic daily requirements. I’ve slowly observed and learnt that family is a big deal in kenya. and I love that. that being able to communicate with your family is so much more important than maybe eating that third meal that day. without your family, what do you have?

I have never once in my life used earplugs, at least not that I can remember. but here, they are a godsend. they stop me waking from the constant howling of dogs throughout the night, from the screaming preachers who start their spiels at 5am, from the roosters crowing and the matatu horns blasting.

my host sisters singing this song to me “mary had a little lamb, little lamb, little lamb. mary had a little lamb, it was as white as victoria”.

during high school, I dreamt of the day I could fluently speak french. or any language fluently other than english. well I came close, but never quite made it. but the urge to be able to speak swahili is so much stronger. the inability to properly communicate with everyone in a country you visit is infuriating. while most people here speak fantastic english, the further out from nairobi you get, the less and less they speak.

my new friend, sierra from the US, said something on our way to the naivasha medical camp that really struck me. “people at home have everything and yet they fight over nothing”.

down from the hills, ’round aching bones to my restless heart

oh lordy, yesterday was amazing. if anymore adventure was squeezed into the day, I’m not sure my heart would’ve coped!

advertised to me by fellow volunteer kristy as ‘going to the equator, then to a waterfall then hike mt longonot’. I was slightly apprehensive about the word “hike”, but hey I hiked a whole lot of hills in turkey ad managed to survive – and that was in 30 degree heat! it’s ony been low 20’s in kenya for the past month or so. definitely will survive, surely, hopefully, fingers crossed.

first stop of the day was to the equator. it was pretty cool but I secretly had hoped to see a massive line pained on the ground, but to my disappointment there was just a sign. still pretty awesome to be ale to cross off ‘stand in both hemispheres at the same time’ my bucket list.

the next stop was thomson’s falls over the ewaso ng’iro river, in nyahururu, east of nakuru. a beautiful 75m waterfall.

we hiked to the bottom of the waterfall, a seriously steep walk down huge steps which started the muscle ache in muscles that I didn’t even know I had that would last all day. the walk down was crazy, and incredibly slippery due to the constant spray off the waterfall. my pair of walking shoes I brought from home are so uncomfortable, so I decided (in true australian fashion) to do the entire day in my thongs. well actually birkenstocks, but basically the same thing.

the hike back up to the top of the waterfall nearly killed me. infact, it was the first of very many times during the day that I thought my heart was going to give out. legs were aching, infact they were burning, my heart was racing and definitely breathless. I may have lost 7ish-kgs since being overseas but in no way am I any fitter, nor is my heart any more capable with strenuous exercise. but I made it up to the top, albeit it took a while, and I didn’t die! win number 1 for the day!

after a quick lunch break in naivasha – where I was hardly hungry but managed to eat a little, we headed for mount longonot. we started the hike pretty far from the very bottom of the mountain. it started pretty easy, just a slight incline. then it started getting hard. long story short, and after an hour and a half of hiking up some of the steepest climbs I’ve ever had to do (all in my birkenstocks), I finally made it to the top. may have been in SVT for the entire time but I took it slow and made it up. and bloody hell, it was so worth it.

mount longonot was once an active volcano, infact it’s still classified as active, however the last time it erupted was in the 1860’s according to kush, the guy who took us around during the day. when it erupted last, it split lake naivasha into a lot of smaller lakes.

this isn’t my photo, but I couldn’t get one that shows the vastness of the crater, so incredible. apparently a couple of months ago, two hikers got too close to the edge, fell off and not been found. so either they died or they’re living like proper bear grylls at the bottom.

at the top, I might be smiling but every muscle is shaking, heart is racing and I’m hyperventilating – but just like the imagine dragons song… “I’m on top of the world”

the view from the top

the end!!!

a very exhausted hiking group

I got back home at about 8pm and after two bowls of pasta for dinner (carb loading at the wrong point of the day), I literally fell into bed. everything hurt, even muscles that I didn’t know existed. the most exercise I’ve done in months, and it was bloody fantastic.

night has always pushed out day

mornings in nairobi

0645hrs. waiting for my pick up to go hike mt longonot (an old volcano with an incredible crater), visit and hike down to the bottom of thomson’s falls and stand on either side of the equator. the preacher has already done his hour of screeching in the street just outside our house. then comes up to me and shakes my hand, giving me all of god’s blessing on this ‘very beautiful but cold morning’. people are already up, awake and going to work. the reggae just got switched on so we’re rocking out to some ‘rastafarian ganja’ beats, at the time of the morning. everyone says good morning, with a smile.

I could easily become a morning person if all that happened every day at home.

I’m not gonna spend my life being a colour

conversation with my 5 year old host sister, vicky, who loves the fact we almost have the same name.

“why your skin is white?”
“I don’t know, why is your skin black?”
(she’s laughing) “I don’t know! does it change colour?”
(me laughing) “sometimes it does, if I go to the beach!”
(she’s puzzled) “mine is always black. but we are still the same?”
“yes vicky, we’re exactly the same”
(she’s relieved) “good… you have two hands as well, me too.”

love knows no colour.

there are places I’ll remember all my life

medical camp number 2.

this is the medical camp I’d been looking forward to since my orientation on july 1. held in naivasha on august 17, it was run in conjunction with KCC (kitendo children’s charity), NVS and kijabe mission hospital. 10 of us volunteers from NVS helped out on the day, with pretty varied backgrounds. nurses, nursing students, med students, an ex-army medic.. most of us were medical in some way or another; it really doesn’t matter if people don’t had a medical background because there’s always something for people to do!

up at 6am, to meet at 7am, left by 8am (by the time some stragglers came late), arrived by about 10am, worked until 4:30pm, left at 5pm, home to nairobi by 6:45pm. it was a long day, both in the sense that I’d been awake for ages, and that it was both hectic and intense at certain parts of the day!

as we arrived, everything was pretty much set up and organised, unlike the last medical camp in nakuru when we sat for ages waiting for tents to be set up and tables brought in and chairs brought from a church 15 minutes away etc etc. it was clear that this medical camp had been 6 weeks in the making, people had been organising it down to an absolute tee, to ensuring we had more than enough medication and staff to deal with loads of people. the camp was directed towards women, having breast cancer screening and cervical cancer screening areas, as well as general check ups.

arriving at the site, it was surprising to see that everything was already pretty much organised. tents were already pitched, PA systems already installed, patients already started to arrive. if anything, it was the staff (and us) who were holding up the proceedings. the staff wanted to welcome us with a prayer or two, a few worship songs and morning tea. if there’s one thing I bloody love about kenya, it’s that regardless of what job you have, regardless of how busy you might be… everybody has time to take tea.

what our pharmacy looked like

I started the day in pharmacy, not really fussed where I work in medical camps like this – I know that you’re needed wherever you are. I was expecting that pharmacy would be pretty cruisy actually, oh how wrong I was. wai and I were run off our feet. none of the medication had been pre-packaged into smaller ‘take home’ packs, huge 5L bottles of liquid paracetamol and amoxicillin had to be decanted into small bottles for children… all the while receiving the patients cards and trying to decipher what the doctor had prescribed, then running to the doctor to clarify what they’d written, then running back to do instant drug calcs. not even kidding, it was the most mentally straining work I’d done since my last placement shifts last year. and they use weird abbreviations here. paracetamol gets shortened to PCM. metronidazole is shortened to MTZ.

I could write my own drug calc quiz on examples of the day;

if our paracetamol tablets are 500mg & a patient has been prescribed 1g PCM TDS 5/7, how many tablets do they require?

a patient has been prescribed 400mg MTZ TDS 2/52. tablets are 200mg. how many do they require?

holy shit. it really hurt my head. but after 2 minutes of floundering around, I had to mentally slap myself to get my shit together and do it quickly… the line was growing exponentially. I am in total awe of my friends who started their careers this year as nurses or paramedics and have been doing this for months now. crazy.

pharmacy friends

it’s also living proof that wherever you are in the world, doctors have the worst handwriting ever. us running back and forth to the doctor should have given them the ‘gentle’ nudge for them for realise that they should write clearly and legibly. no wonder patients die from errors made from medical staff, I blame doctors handwriting. a note to all you doctors/med students out there, please for the love of all things good and alive, write neatly, so poor nurses like me aren’t left guessing what you want the patient to have.

funny story that made me laugh: was about to get the drugs together for one woman when I needed to double check with her doctor. so I asked her who she saw. she pointed in the general direction of two doctors, and said “the black one”. I actually laughed out loud.

putting drugs into packets

kelsey and kristy in pharmacy

another thing that’s different is how they write the instructions for taking the tablets. none of this easy to understand “one tablet, three times a day” or “two tablets, twice a day”.. you just get told 1 x 4. does that mean one tablet four times a day, or four tablets once a day? apparently patients understand it here, but it definitely took me a bit to get my head around. so the instruction for taking the amoxicillin above is ‘two tablets, three times a day’. right…

working in triage

a nurse from australia, kristy, started working in triage and said to me at the start of the day that we should swap half way through so I get a chance to work there. it’s not as exciting as it sounds, really you’re not triaging anyone, you’re just taking vitals, and not even manually.. they had automatic BP cuffs, which I was glad to get rid off and do it manually, I don’t trust the auto ones. one 24 year old comes up and I take her BP, get a reading of 220/150. shit. so I do it again, on the other arm, same result. she got really anxious when I went to do it again on the other arm, and I just said something about not hearing it correctly so I had to check again. avoid elevated anxiety in patients at all costs. but when I got the same result, she must have read it on my face and asked me how bad it was. I have a horrible poker face, in fact I can’t lie to save my life. I was as diplomatic as possible and just said that it was pretty high but she was about to see the doctor and they’ll discuss it with her. she goes on to tell me her whole family has high blood pressure, and she doesn’t want to be on medication forever… it’s too expensive. bloody hell.

william, an ex-army medic now osteopath, doing diagnosis work for patients

my little follower, who when I asked what she wanted to be when she grew up, she said she wasn’t sure, so I said how about a doctor? and she looked at me blankly, unsure of if I was joking or not. I told her if she works really hard at school, she can be anything. cue: massive smile from her. melted my heart.

the group

it was such a great day, seeing almost 300 patients. we got back to nairobi at about 6:30 and I had a well earned beer with two awesome girls who were also at the camp, sierra and mollie. absolute legends. a massive thanks to my amazing friends and family who donated, I used approximately AU$55 which was my donation towards the purchasing of medications and supplies. while it wasn’t as large as the one in nakuru, it serviced women in an area who can’t afford healthcare or simply can’t reach it easily. people travel from far and wide to come to these medical camps, which is why they require so much planning… so the word gets out & more people can be helped.

the life and the death of the wild at heart

well my samples were handed in, then 24 hours later my favorite lab technician, peter, read them for me and good news, I’m tuberculosis free! it as rowdy so eloquently put it..
“TB FREE SINCE AUGUST TWENTY THREE!!!!”!

its a bloody miracle that somehow after seeing patients who have it, none of their sputum entered any of my orifices and I’m not showing any signs of exposure.

happy days! co-celebrated my negative result with my three month anniversary of leaving home 👍

when you try your best but you don’t succeed

wai – my new friend from the medical camp in naivasha – wrote of another heartbreaking story yesterday. a patient was brought into the clinic without a pulse. according to wai, an emergency nurse from malaysia, the patient clearly hadn’t been ‘down’ long so went to start CPR, only to be told by the staff (of which there are no doctors) not to worry, that they wouldn’t get her back. probably as they didn’t have anything to resuscitate her with… no adrenaline, not even an ambu-bag.

the girl was not even 16.

yesterday, she died because of her circumstance. because of a lack of resources. because she didn’t live 5 minutes from a level 1 trauma centre, nor have some of the highest trained paramedics in the world at her call. because even if she was brought back, being intubated requires not only a specific skill set but also the resources in the first place, which is unlikely to be seen in a rural sub-Saharan african clinic. having manual airway support and requiring a cocktail of drugs to keep her pressure up requires a clinic to actually have the oxygen and drugs in the first place. and if she then needed ICU care, where would she go? who funds it?

I can only surmise that the staff in this clinic realise all of these potential questions and come to a point where they’re really quite helpless. that the situation is hopeless.

our health system in australia is somewhat in pieces at the moment, it has been for a while. entire wards being shut down, ambulances ramped at hospitals for hours, beds being unused, a severe lack of staff, no support from the hiring body, overworked, underpaid, undervalued. but fuck me, at least we have one. at least it’s not helpless or hopeless. the staff I’ve worked with have always worked tirelessly to ensure a patient gets the most care possible. it may not always be one with a big happy smile on their face, but it gets done. god, we worked on a patient in an ED for over an hour trying to bring him back. he’d been down for sometime but the doctor was tireless in ensuring he’d done absolutely everything for this guy until we called it quits.

and, at least 15 year olds don’t die in australia just because of where they live. even the most rural parts of the country have volunteers/paramedics on call. anyone of us could’ve been born here, that could have been any one of us. I can’t believe I’ve had to attend patients with a broken toe nail or period pain, that I’ve had patients walk into an ED complaining of a hangover, that people call 000 for the man flu or ‘liver pain’ (an actual job I went to) when people are actually sick and dying.
honestly could count more people on my fingers and toes who would benefit from seeing life on this side of the world.

if I stare too long, I’d probably break down and cry

I’ve seen or heard about of a lot of crazy things here, particularly medical things.

at the medical camp on the weekend, two volunteers are also nurses, kristy from perth, and wai from malaysia. kristy has been working in a hospital not too far out of nairobi, and been in their emergency department. now for an emergency department, one would assume they would be prepared for an emergency. alas, this ED doesn’t have a defibrillator, or adrenaline. holy shit. pretty sure they’re the two stock standard things required for a place to be called an emergency department. oh and if anyone has a blood pressure higher than 140 (systolic) or 90 (diastolic), even just by 5mmHg, they receive a dose of IV frusemide and nifedipine. talk about overkill.

wai is working in a small dispensary in kajiado, and uploaded this photo yesterday asking people to guess what caused the scar.

I’ve seen a whole bunch of kids with horrendous scars here, including one kid at ray of hope who fell into the fire pit as a baby where his grandmother was cooking dinner. his chest, neck and abdomen is completely scarred, looking very much like the picture above. so that was my guess. a few other people guessed burns too or acid attack… but this is actually what muscle and skin necrosis looks like after a venomous snake bite. I would hate to imagine the agony the poor kid must have been in.

hold me fast, I’m a hopeless wanderer

my theme song at the moment

received another beautiful email from ‘a note from the universe’

“it’s perfectly normal, victoria, that when waiting for a really big dream to come true it seems like it’s taking forever, you wonder if you’re doing something wrong, and you feel like you should just be happy with less.

but I promise you, no matter how long it takes, once it happens it’ll seem as if time flew, you’ll wonder how you ever doubted yourself, and you’ll feel like you should have aimed a little higher.”

feeling so unwell and lacking in energy at the minute (felt better on the weekend and now I’m back to square one). trying to make every day memorable and worthwhile when you feel like shit is hard, until I remember how long I’ve been wanting to be here and do what I’m doing. and seeing other people who are a lot sicker/worse off than me makes one feel a lot less sorry for oneself.

so… onwards and upwards! back to the doctor tomorrow before work. #powerofpositivethinking

smile an everlasting smile

guess who’s moving to tanzania for november and december?

that’s right.. it’s not taking healthcare to just kenya anymore, now it’s taking healthcare to east africa! I know I said I would be in kenya for the rest of the year, but now that I’m here, I feel like four months will be plenty long enough. it will definitely be time for a change by november. and what better place than moving just ‘next door’, to the land of the serengeti, ngorongoro crater, zanzibar, mount kilimanjaro. I’m so excited!

“travel is about the gorgeous feeling of teetering in the unknown”