Day 9

Hello friends, family, and newcomers. Welcome to or welcome back to my blog where I am documenting the process leading up to and during my first humanitarian mission to Eldoret, Kenya.

Today is Monday, April 7th, marking the fourth day of our clinical work. I've been here for ten days now, and I've grown very attached to this place. I believe returning home will be quite challenging.

New colposcopy equipment. So beautiful.

We began our day with breakfast at the hotel before boarding the van for the morning drive to the hospital. After our morning meeting, I joined Dr. Bill in colposcopy, where I spent the morning learning to operate the new colposcopy machine, how to grade using the Swede scale (a tool for predicting high-grade disease), and how to save the information on the computer. Colposcopies are performed for women with abnormal pap smears, those who test positive for HPV, and to screen for cervical cancer. In Kenya and other parts of Sub-Saharan Africa, this is extremely important as HPV and cervical cancer are highly prevalent.

This morning, I valued the opportunity to learn something new. It was intriguing to navigate the new system, complete the paperwork, and participate in the patient examinations. One patient had a large lesion around her cervix, which Dr. Bill indicated was likely stage III or stage IV cervical cancer. She was scheduled for further testing, her biopsies were sent for analysis, and social work was involved. Today evokes more emotions since cervical cancer is largely preventable. HPV vaccinations are uncommon, pap smears are not regularly performed, and women do not consistently follow up with GYN. Additionally, these discussions are not culturally prevalent, leading to a lack of education. The campaign has initiated efforts to change this narrative, but we are only beginning to address the issue.

After we finished seeing all of the patients for the morning, we went up to have lunch. Today, my meal included rice, chicken, veggies, and I decided to try some mango. I have never tasted a better mango; it was incredibly sweet, very juicy, and the color was perfect. Although I have been avoiding fresh fruits due to concerns about GI upset, I learned today that the fruit is cut in the hospital kitchen and most of the food we eat comes from Dr. Mabeya's farm. So, I decided to give it a try. So far, so good.

After lunch, I headed to the fistula ward. By this time, many women had undergone surgery, and I was conducting post-operative checks on drains, ostomies, and other related aspects. Some women required pouch changes, so I collected my supplies, enlisted the help of some local nurses, and we went around changing the necessary pouches. I also had the chance to speak with two young women who might be receiving colostomies.

Sharon, one of the wonderful social workers at the hospital, the young girl, and I went outside to discuss the procedure, their comfort with the care plan, and to address any questions they might have. Most of the concerns were about being able to live a normal life, attend school, and have friends. Although I don't have an ostomy myself, I did my best to reassure the patient that they could still enjoy all those things. I placed an ostomy bag under my shirt, danced around, ran, and sat down. The patient could see that the pouch was not visible under my clothing and that they didn't have to disclose or show it to others if they didn't want to. Empowering these patients and helping them understand the benefits is incredibly important. After speaking with both patients, they agreed to the surgery, and I marked them. This was a unique experience for me. I have learned much more from these women than I believe I have taught them during my time here.

In the afternoon, Karim, Becci, Sharon, Melanie, and I visited the Beyond Fistula house to present the kids with the supplies, books, and crafts we had gathered for them. We also brought candy, which they enjoyed once we had distributed everything. These supplies will assist them with their schooling and offer them a source of entertainment.

Upon returning, I joined Karim, Samuel, Dr. Anthony, and Dr. Wissam in the office as they reviewed the patient list to update the document for the next day. We also organized the surgical schedule and everyone's assignments for the following day. This process took several hours, and we were pressed for time because we had a celebratory dinner to attend. Nonetheless, we completed the tasks and swiftly returned to the hotel to freshen up.

I changed into my nicer clothes (jeans, a t-shirt, and a cardigan), got into the van, and we headed to dinner. I was thrilled about this because we were going to enjoy more traditional dance and have dinner with everyone from Campaign 52 and the Gynocare staff. Upon arrival, dancers greeted us, and we were led into the dining hall, where we spent the first 10 minutes dancing around. I don't think I've ever had more fun, laughed so much, or smiled so broadly in my life. After we finally sat down for appetizers and drinks, they encouraged people to join the men and women dancing. I was pulled up, and I'm glad I didn't stay seated because I had a blast. The ladies taught me the moves, handed me their sticks to dance with, and for once, I didn't care how I looked, who was watching, or if I seemed silly. I was having the time of my life, and nothing else mattered. It was such a wonderful feeling. After dinner, the men decided to smoke cigars while the women went outside to sit under a canopy and chat.

We had plenty to celebrate and be joyful about, as today we reached 130 cases. As the night ended, we loaded the vans and returned to the hotel to prepare for bed. I brushed my teeth, washed my face, changed into my pajamas, and climbed into bed.

Today, I experienced incredible highs and some lows. Every day feels surreal, and it's hard to believe we have just three days left. I'm not ready for this to end, so I plan to savor every remaining moment. Until tomorrow :)

All Love,

Meg