wish you were here

There's nothing like reflecting on your day while watching the sun set behind the acacia trees. Indeed, today is a day that I need to reflect on. We visited Mburikani Village Clinic, the most unique health care service not only in this area, but probably in the world. The clinic provides completely free health care to anyone. Literally. If your premiums are too high or you can't afford co-pays, come to Mburikani, come one come all. I can say without a doubt in my mind that the care is exceptional, better than some clinics in the United States. The clinic was started by a woman from Chicago who had visited the area many years ago and was so touched by the people of Mburikani, she asked what she can do for them. Her offer started a mobile clinic, operating out of a single vehicle and has expanded into an inpatient ward, and outpatient ward, a pharmacy, a lab, x-ray and diagnostic center, a community outreach program, and more recently a voluntary testing center where people can come and get free testing and education for HIV. But there are rules. You can't get tested for HIV without first getting educated about it. Hello primary prevention! And it doesn't stop there. In the waiting area for the clinic, patients view slides in the local language about essential primary preventative measures to promote healthy behaviors.
The director of the clinic took us on a tour, with our first stop in the pharmacy, which interestingly had boxes of some sort of medicine from Hospira (Midwest represent!). One of the best pictures I took in the pharmacy was rows upon rows upon rows of folic acid supplements for pregnant women. My maternal nursing professors would be proud.
Then we checked out the garage which housed about 20 motorcycles which staff use to travel all over to provide basic medical care and education, compromising the community outreach program. The motorcycles had cases attached to the back of them to keep medical equipment and medicine. We also saw the new mobile clinic, which they had just got only 2 weeks ago. This was probably one of the most impressive operations I have ever seen. The trailer had an examination room, complete with examination table and sink, a pharmacy window and a waiting area and it's all on wheels! Interestingly, it had an Illinois license plate (again, Midwest represent!)
We then checked out one of the interventions developed uniquely by the clinic called mobilets (mobile toilet) which is essentially a port-a-potty that the clinic provides free to villages to help reduce the contamination of river water by human waste. All the village members have to do is dig the hole!
The lab had everything that a lab in a US hospital had, but more specific instruments for the types of diseases and illnesses specific to the area, such as measurements for CD4 cell count to monitor the progression of AIDS.
The inpatient area housed 4 wards staffed by about 10 nurses. It was a great opportunity for me to see the nurses here in Kenya at work and the resources they have. Many nurses who are educated here often go to Europe or the US to work as it is a better opportunity for them, but maybe someday I will come back to Mburikani as a nurse.
The staff at Mburikani Village Clinic live on site in dormitories. They work 6 days a week, 8 hours a day. There are about 22 nurses, 5 physicians, 1 pharmacist, 3 pharmacy techs, 8 physician assistants, 1 radiologist, and 4 lab techs. Mburikani fills over 200 perscriptions per day and have about 40 beds in the wards. They are building a larger ward that will hold 80 beds.
Much of what Mburikani sees daily is malnurtrition, diarrheal disorders, HIV, TB, respiratory problems, hypertention, and a bit of diabetes. I mentioned before that one of the largest threats to Kenya (the people, wildlife, and agriculture) is the drought. The drought has made malnutrition a huge problem, especially for children and elderly. This is the face of global warming, and whoever says that global warming doesn't exist needs to come to Mburikani. The glaciers on Kilimanjaro are nearly non existent, cutting off the water supply to much of southern Kenya and Tanzania. No water, no grass, no crops, no animals, no food. But Mburikani recognizes the issue at hand and has implemented environmentally sustainable resources to maintain their clinic, including solar power.
Seeing Mburikani is like seeing a dream come true and it should be happening in more places. Tomorrow we are visiting a government run clinic and I am interested to see how the two compare. Certainly that is where I will be bringing a handful of blood pressure cuffs that were donated by Linda Mulligan because this is where they are needed. The government run facilities don't compare the the privately operating Mburikani and of course, they don't provide free care.
Every day I am getting a bigger picture of the state of health care in Kenya and it makes me more and more passionate about public health in developing countries. Certainly this experience will show me path that I hope to take my career as a health care provider.
I'd love to hear from you all about what's going on in your lives. Hope all is well!