The Adventure Begins...Kisii 2010

As of now, we have been in Kisii for four intense, long, tiring,exhausting, crazy, hectic, chaotic....magical days. At this point, the team has (almost) seen it all. Visual Examinations, Cryotherapy, LEEP...HAIL IN KENYA...you name it, and we have already checked ( I mean, ticked) it off our list. Arriving from various jet-setter destinations around the globe, we met in Nairobi on Saturday, August 21st.

Our Team: Kenya, Carol, Monica, Rashmi, Raji, Renee, Rajaa, and Anu

From the get-go, trouble and his pal misfortune stared us in the face. One of our medical bags, which contained important supplies like batteries, gloves, and swabs was missing; probably stuck somewhere in Cairo! But of course, Carol, with her everlasting supply of patience and good will, kept calm, while urging Mike (the driver) to check up on the bag' progress. (Thankfully, on Tuesday morning, we had our bag and all of its sorely missed contents). On Sunday, we left Nairobi in a van, packed tightly with bags, equipment, suitcases, and, lastly, ourselves. And, after this 4 hour drive of picturesque views and varying weather patterns, we arrived in Kisii at the Ufanisi Resort, a place of untold comforts. Now, when you think of Africa, you probably think mosquitoes, dirt, no electricity, no running water...you think that we all must be roughing it big time, reeking of bug spray, going without showers, and what not! The future may or may not hold that in store, but for now, we are enjoying the wonderful Kenyan food, hot water, and wonderful lodging. On the night of August 22nd, I know, many of us slept unsoundly...not because of a lack of comfort, but due to the agonizing anticipation, the excitement, and the uncertainty we were facing. Since this was PINCC's first visit to the area, we were unsure of what was in store for us on our first day.

Kisii level five hospital is used to seeing high risk cases: it didn't get that level five status for nothing. Standing resolutely in the hustle and bustle of kisii life, the hospital is fairly large with several floors and passageways galore. Here, in the Gynecological Clinic, we set up our supplies and the equipment. With 5 rooms for examinations and procedures, the team set to work on the long list of women who always appeared promptly in the morning, forming a line outside the door. The first day, Dr. Kenya and Dr. Rashmi practiced basic examination practices and worked with the nurses and Dr. Mutiso, the resident doc, to develop the skills that would transform these fledglings into lean, mean cervical cancer fighting machines. Though the first day saw very little of the more advanced procedures, the nurses were tested and lectured by Dr. Kenya, who handled the training with a masterful prowess that takes years to cultivate.

The place was hopping with activity as Carol sought to project her expansive calm across the area, Dr Kenya and Dr Rashmi coached the nurses, Raji stood in for whatever job had to be done in the procedure rooms, Renee flitted around like an energetic social butterfly, and Rajaa and I reigned as the Data Entry Queens (you may address us as such!). Almost 100 women were registered that day...and 40 were examined. You can imagine the heartbreak we felt when we had to start turning away some of the women. Judi, who handled registration, near begged us to admit more and more:

"This woman is old...almost ancient. And she walked and walked and she had surgery last week and she is on crutches and her daughter won't ask her husband for the car so he can drive her and she's so so so so so ill! We have to put her first on the list!"

As we worked...we developed a routine. We arrive at 8am. The medical professionals join Dr Kenya for a powerpoint lecture that was delivered to the nurses. And Renee, Rajaa, and I would head to the clinic, where we would set up the registration and data entry station. I have to add, just as a little rant of my own, this data stuff would get so convoluted and well...silly! Every person had a unique PINCC number and a hospital number. Thinking we were these brilliant hotshots, we made the PINCC number the same as the hospital number, so things wouldn't be so random.

Little did we know, that almost all the time, people would be assigned the same hospital number...so Rajaa and I would stomp over to the med students doing the number (hands on
hips, frowns on faces) and demand the mistake be fixed...well maybe that's an exaggeration...Rajaa and I are far too nice :)

Anyways, after working for some time, the 10 o'clock tea arrived. Now this tea...it's a godsend. I'm pretty sure it was the wafting,enchanting scent of the chai that prevented any impatience and squabbles. The sight of this tea sent all the nurses into a sighing frenzy. And as soon as they cleaned the last speculum of their last procedure, they ran to the

tea and circled the canisters like zebras at a watering hole (Like the African wildlife analogy?). Soon, even we started awaiting the arrival of the buttered bread and the red and blue canisters.

On Tuesday, directly after the tea, Dr. Kenya oversaw the first Cryotherapy. Dr Mutiso and the nurses clustered around her (oohing and ahing when necessary) and eagerly watched Dr. Kenya perform the freezing treatment. It would get so crowded during each procedure that Dr Rashmi and Raji would literally be swatting some of the nurses away: "THERE'S ANOTHER PATIENT ON THE OTHER SIDE! YOU CAN'T JUST LEAVE THEM THERE!" I guess this behavior is a testament to their dedication to their profession, and really, these nurses are incredible. In the next post, I'll give you a closer look at some of them.

Thursday was crazy. Crazy, crazy, crazy. Carol says that the week worked out perfectly though. Monday was very slow, almost sluggish, as everyone tried to gain their bearing. Tuesday and Wednesday had few procedures, but there was enough to allow the doctors and nurses to practice. But Thursday, oh Thursday. On Thursday, this super blend team of PINCC and Kisii volunteers and medical staff finished 8 LEEP procedures and 3 CRYOS. Though we only saw 35 patients, almost all the major procedures ended up being on that day. Only the sheer will power
and energy of all present could have made this possible.

Right now, it's Ramadan. And Kenya and Rajaa are fasting. I felt it necessary to add, after that bit about that insane day, how amazing they have been, even without eating during the day!

Today is our last day in Kisii. In the morning, we examined and treated 25 patients...even though today is a holiday. Today, Kenya's constitution is getting a makeover. So now, the president has a term, there are checks and balances...and it's more democratic. It's a happy day for the most part, and people really believe that the passing of this bill will bring more rights for more people. Anyways, while people were in their house watching the proceedings or having little parties around transistor radios in street corners, the PINCC team and the Kisii nurses were hard at work. But, after all, it's not all work and no play. As a sincere thank you, PINCC treated the nurses to a lunch at the Ufanisi resort where we are staying. With enough ugali ( a mushy, corn based, rice-looking lump of stuff, which Carol and I love) and chicken for all, we dined together as one happy, content, successful team.

More about these festivities later! Food calls!