August 2013 -- Notes from Bungoma by Nurse Roseanne Packard

Saturday, Aug. 17 Eight of our group arrived Saturday evening at the Mennonite Guest House (MGH), greeted each other and had out first meeting to plan our week at Bungoma Districtl Hospital. Some of our group were lucky enough to have had a side trip to Nairobi Regional Park Game Reserve today and spotted lots of plains animals…up close and personal. Three more will join us at Bungoma on Sunday.

MGH is set amidst lovely gardens and rooms are very nice.

Sunday, Aug. 18 was travel day to Bungoma. Some took a 9 hour van ride across Kenya towards the west through the beautiful hills and valleys of the Rift Valley with deep greens of the fields contrasted with the red earth The weather was changeable and beautiful cumulous clouds accompanied the whole way. Our driver, Mike Muthama, was a pleasure and answered all our numerous questions. Others opted to a flight and only a 2 ½ hour ride. We rendezvoused at the Bungoma Countryside Hotel. We will be here all week. We are two to a bungalow with our own bath.

The food is country style, potatoes, rice, shredded salad of some type and stew of either chicken or beef, pineapple for dessert. It is relatively the same every night, but the conversation is lively and improves the appetite.

Monday Aug. 19 was D Day. The first day is always a bit difficult as we learn our parts and place in situ for the first time. It's sort of like the first rehearsal of a local play. We have 4 exams rooms and one very small office. Our clients, the women of all ages, stations and education crowd to us for information on how they will be seen. The clients are very eager for this free service which impacts on their reproductive lives. Over the next several hours, question after question, step by step, both of ours and the clients' needs fell into place to get this mobile clinic in a foreign land up and running. Carol carefully answered all our questions. We had some missteps, but they were few.

We take a tea break about 10 for a sweet samosa type bun, a sausage and tea. Lunch comes about 2, of chopped kale, rice, potatoes and some type of stew. Notice the similarity here. But we sure eat it all.

The staff has showed up, doctors, nurses and clinical officer students and most are eager to learn. Our PINCC doctor clinicians are eager to teach. It is a good combination. As everywhere, the staff vary in their skills and commitment, but overall it is a motivated group. We saw 30 patients today, including LEEP. Not bad for a first day. Our Kenyan nurse- midwife, Ruth Kitai, taught a wonderful class in the waiting area, full of lots of humor, which broke the tension for the clients sitting, waiting, wondering.

Tuesday, Aug. 20 and we're moving along a good clip and we saw 40 patients today. We did 2-3 LEEPS. We couldn't train on the cryo as there was no gas. The problems we encounter in this multi-faceted endeavor seem small as the Kenyans are a pleasure to work with; polite, soft-spoken, amenable, flexible with a sweet graciousness. All the clients, doubly so…so gracious, so grateful. We often receive blessing as they exit the exam rooms after their stressful exams. We saw 50 clients today and found four cancers. One was quite advanced. Our PINCC staff can find this very hard to process as we assume the client would survive in the US, or at least receive supportive palliative care.

Wednesday, Aug. 21 Our clinicians feel the medical training is going well. All work so hard in the small, crowded rooms, hour after hour. At 3 pm every day, our Medical Director, Dr. Virginia Hanson, leads a class for the Kenyan staff. Towards the end of the day, about 3-4 pm depending, we start to gather up records, clean remaining instruments, and re stock rooms. Our office people keep us on track, which is not easy as we try to be fair re the first come first served principle, but at the same time, flexible. It ain't easy. Others of staff work hard to keep ahead of data that needs to be entered and backed up. The cryotherapy is up and running and we're doing our training.. Tonight the clinicians had a meeting to evaluate the Kenyan staff and identify those who may need more support in the learning process.

We had a special treat as about 30 Community Health Workers came in from far and wide for a class today to learn about prevention of cervical cancer and then spread the word.

Tonight we went out for pizza. We ate by candle light as due to the rains, all lights were out. This usually happens with a hard rain. We saw 50 clients today. All agreed, the day felt much more "fluid."

Thursday, Aug. 22 In spite of our breaks for tea at 10 and lunch at 1: 30 or 2 , the staff gets weary in the afternoons. We do keep going, but this is not for the lame or halt. I never work as hard all year as I do with the few weeks at PINCC. The staff knows we are leaving and I honestly feel they will hate to see us go. Today volunteer Mimi Pirard, who is a professional singer, treated our clients to a lovely French ballad. They returned the favor and sang to us. Saw another 50 clients today.