Partners in Global Medicine
Posted on 17 February 2012 | No responses
by Veneta Anand
Today was a very productive day. We met with curriculum development from the University of Nairobi, Department of Family Medicine. They are trying to develop a new faculty that is unique. They were interested in an integrated approach to health care with other disciplines. This would make them the leading school in Kenya. This system is similar to the practice we have in Canada. It is interesting because the approach we are all collectively using is how we can learn from each other. So we are learning about rural medicine from them as they tell us about the challenges of providing care in marginalized communities that are remote.
This is something relatable to Canada as many communities with transportation issues and are very isolated. It is good how 2 countries that are so different can work together to enhance care in their respective countries.
After the very early breakfast meeting, we split into twos and tried to find contacts. I went with Corrine, Department of Health and Sanitation. We literally went to Kenya Medical Training College to knock on doors to try to find relevant people. We were lucky that the first person we met was the Head of Water and Sanitation. His mom worked at the College and was the Registrar. We met with them and ran into department heads of some of the other faculties. The gentleman then decided we needed to meet with Government – so we headed over to the Ministry and had an impromptu meeting with the Chief Public Health Officer.
We then proceeded to meet other relevant government entities. It was serendipitous how we ran into all these people. We were not expecting to have face to face meetings but more so get contact info – but to actually meet with them was fantastic. As a result of our meetings we are going to be delivering a presentation to 18 department heads in the morning about integrated approach to health care.
We met with some more Canadian and American physicians working in Kenya. It is amazing how small the world really is. Everyone participating in Global Health crosses paths at some point in time. We shared experiences – some of them were heart breaking, others were scary and some left us speechless.
There were talks of being the only physician for 250,000 people and working for 3 years straight with no breaks (a real passion and dedication to your profession and the health of others):
-working in medical tents after land mine explosions;
-being mobbed by people desperate for medical aid and literally fearing for your life;
-having children with AK47’s escort you into abandoned buildings;
-having to take care of amputee victims that were preganant but had infections at the stump;
-being evacuated to neighboring countries as a result of attacks and mass genocide
the list goes on…….
The Kenyans have been amazingly kind. A visitor is a blessing – and the kindness that was shown to us today was humbling. Everyone welcomed us with open arms and were genuinely interested in working with us. It is great how people from all over the world can set aside their differences and work together to enhance individual experiences.
Consultation & Assessment
Posted on 16 February 2012 | No responses
by Veneta Anand
The assessment of a partnership continues in Kenya. We visited one of the larger hospitals in the District to see the type of facility they have there and what we could do to help develop their program. The journey out was very long – the roads were filled with rubble and dusty. Locals walked along the side of the road and were often seen laying in ditches as they took a break from the blazing hot sun. We drove through many communities and witnessed local markets and fruit stands.
The hospital was interesting. In some aspects quite advanced- in others not so much. They had a 6 bed ICU unit and there was a little baby in one of the beds – barely the size of a pillow. It was heart wrenching to see all the tubes inserted in him. The maternity ward was quite well established – but since they deliver such huge volumes (400 per month) mothers often shared a bed.
We were able to meet with some Medical Residents that gave us insight why they joined medicine. It was refreshing to see their passion for their profession and dedication to their people.. It strengthened our resolve to help improve the capacity of the learning institutions.
It was also great to see a pharmacist hard at work!! Pharmacy is very similar to Canada at this place – BUT they had different departments for different diseases. Eye pharmacy was different than Cardiovascular etc. Thankfully they had electronic records that helped monitor interactions. Due to the stigma with HIV they developed a new HIV pharmacy very far from the main site. There is still a stigma associated with HIV. About 7% of the population is affected.
Alcoholism and depression (leading to suicide attempts) are also very prevalent. Alcoholism leading to family violence is huge and an opportunity to develop social programs. Depression related more to inability to provide for their families. A very difficult thing especially when families have at least 4 kids at a minimum (the number of kids puts men in a higher status category as it proved their virility)
It is our last day at the camp before we had to Nairobi. The staff thanked us with a song and dance (which we all participated in). They baked us a beautiful cake and thanked us for our efforts. Our visit to Maasi was short but very productive. We are formulating plans to submit with our recommendations.
We headed into Nairobi with many meetings set up with the University and Government. We have part of the day off so visit a Giraffe Sanctuary. Did u know that the length of their tongue is 18 inches? My colleagues kissed the giraffe – and it was the most ridic sight. Just in case you were wondering… their tongues are like soft sand paper – and they are very slobbery!!
A Day in the Life
Posted on 14 February 2012 | No responses
by Veneta Anand
Today was an interesting day…we visited the Mamas to see how they lived. We got a good perspective into their daily challenges. We walked to the river and carried 45 lbs. of dirty water 2 kms. back. There were cows wading in the river and people bathing. A “filter” is set up so that visually the water looks clean.
Women tend the garden, cook, clean, fetch water, and men tend to the fences. At night, the men are on guard to protect the family sheep from being stolen. Tiny windows, in their round hut homes, are used for shooting arrows.
We met with government officials for lunch and shared great discussions on the needs of the Massai. Mosquitoe nets distributed over a massive distance have decreased malaria significantly.
We had a huge discussion on family planning. Currently, the onus is on the female. Apparently, vasectomies are universally laughed at by males because it challenges their manhood.
We had lots of discussion with the Massai about circumcision. Boys are not allowed to flinch or it is considered a family disgrace. Families practice inflicting gashes and wounds on their kids with dull knives to toughen them up. The person performing the circumcision uses a dull blade as they want the boy to flinch. This means the cutter will live a long life. Female circumcision is now illegal.
Boys can do a sister exchange and get married. Each marriage is worth 3 goats & 2 cows to be gifted to the girl’s family. There is no official ceremony, just an exchange of sisters.
We ended the night with a round table cultural discussion, a walk through the camp and enjoyed constellations without light or pollution. It was a very informative day. We got lots of ideas.
We brainstormed about a colloraborative approach to address one of the eight pillars of the community. We’re going to meet with the clinicians tomorrow.
Jambo from Kenya
Posted on 12 February 2012 | No responses
by Veneta Anand
We finally arrived after almost 2 days of journey. The last flight was on a small plane where we were all in the fetal position, but not because of fear (maybe a little), but because of space.
We saw lots of wildlife on the drive in. There were zebras, and impalas, too!! Staff greeted us with song and dance and a massai warrior.
“Camp” is gorgeous, built with local stone and trees. There are tons of monkeys, gazelles and mongoose on site. The backyard leads to a former elephant conservatory.
The needs here are similar to those in other areas we’ve traveled. Number #3 on the list is brucellosis, which is gastro symptoms from bacteria contaminated milk.
The land here is full of nutrition. After one year, at a state of harvest, their gardens grow everything from carrots to leeks to eggplant. They also grow medicinal herbs.
Water sanitation is huge. Each well generates 25000L. of water each day. They use alot of natural resources, including a biodiesel plant and solar power.
They’re trying to build better cooking facilities, called the Chimney Project, to decrease burns and address the chronic respiratory issues. The goal is for better ventilation and safer cooking facilities for kids and livestock that are living in the round huts.
**this update from Veneta in Africa is arriving in broken pieces by text message
STIMMA taking over Africa
Posted on 8 February 2012 | 2 responses
Its been a while since we last blogged. The holidays are always a special time to spend with family and friends. Through out the season we constantly thought of our friends all over the world. We work in all of these remote communities to help, and in the end we return home and realize that during the process of helping others we mend ourselves. The holidays are about retrospection, and being grateful for those around us and what we have. It is thanks to our global friends we realize how valuable these relationships are.
With the season behind us and our hearts swelling with warmth we start to lay out our 2012 plans. So far we are planning on returning to Haiti in November and to Zimbabwe (in partnership with the University of Waterloo) in August. This is a departure from the previous few years where we have gone multiple times. We decided we wanted to really focus our efforts and concentrate on a few communities and really give all our support to them.
In saying that, thanks to all of your support we were able to purchase a Dump truck for Haiti! It was such a fantastic moment when the truck arrived on site. The workers were thrilled – and with the truck their efforts will go further to rebuild homes. From everyone here at STIMMA and from the Haitians in Cabaret, thank you!
In a mere few days I will be traveling to Kenya. Through STIMMA many opportunities have arisen to work with other NGOs. Another group contacted STIMMA via the University, and now I will be heading to Nairobi to assess the feasibility of a medical clinic in remote Kenya. It is a quick investigative trip that I will be making with Family Medicine, Nursing and Obstetrics. This is a new area for us and I am excited about the possibilities – even for comparing Zimbabwe with Kenya!
I will keep you posted with the help of all of my friends at STIMMA
DAY 14 . Curtain call
Posted on 12 November 2011 | No responses
Posted by Angela Lau
The last night we were here, the town held a celebration for STIMMA, rewarding each member a basket filled with a Salvadoran dessert and a certificate.
Above: Someone thought it was funny to stuff as many people into a mosquito tent.
We had stowed some last items into a bag to give to the family on the outskirts of town. This family had heard of us and seeked us out for help. We had given them 10 sheets of aluminum and hired workers to help them rebuild their roof. They used the old roof to replace the walls of their home which had previously been made of garbage bags. The family had 3 boys last time we were there but as it turns out, the couple actually had 5 children but could not afford to have them all living there, so the other 2 children lived with their grandmother.
Above: Photo of their bedroom and living room.
Back at the school.
Above: Our beloved groundskeeper and friend.
Above: Image of the freshly painted school.
And our finished mural in town square of San Esteban Catarina.
We saw a grand total of 1862 patients in our 10 days of clinic. I am proud to say that 26 homes in the community, thanks to STIMMA and local workers, all have families that will now be sheltered from the rain.
Thanks for all of your donations and continued support, the team has now dispersed, most back to Canada and some still trotting the Central American grounds, we will surely be back in the little town of San Esteban Catarina.
DAY 13 . A brand new morning
Posted on 11 November 2011 | No responses
Posted by Angela Lau
A few of us have been eyeing the Delicious hill for the last few days now to do a morning hike to see the sunrise. We set the alarm to 4:45am and started our walk. It was dark and a bit cool and none of us remembered to bring a flashlight. Luckily, we had the flashlight apps on our cell phones.
Worth it! Closing in on being awake for 20 hours with a lot of people still chatting away outside.
Above: On our walk back, we bumped into a boy riding his bike and selling bread. You can get a large bag full for just $1.
Clinic started today and we saw about 150 patients. Most of today’s patients knew it was our last day here in San Esteban Catarina and the line up was as long as ever. Large families came in today and the poverty was very apparent. Some of their clothes would reek and almost everyone drank from the local river. We treated everyone with worm medication.
Above: This cute little brother and sister definitely knew how to pose.
Above: Little girl clutches onto her new toothpaste and toothbrush.
Back on the construction site.
Above: If you remember from the last post, the family of this house wanted to convert the pig pen into a room. In just one day’s work, this is what was built. They are still working on a concrete floor, but its amazing what can happen in so little time.
Above: This kid lives in the house and is playing with the pig that has now been moved to the living room.
The Garbage Project.
Lindsay had a great idea to help build the community effort. We got 3 large garbage bags and taught the people about picking up litter as it cluttered the streets and caused disease. All the little kids were happily putting the gloves we provided and ran to pick up garbage.
Above: This bedroom was rebuilt. The walls were previously made of garbage bags with a leaky tin roof.
Above: The old aluminum sheets from the bedroom was used to reinforce the structure on the left hand side of the bedroom which is the bathroom.
Above: Adele grabs 2 kids from the street and buys them ice cream. Both were extremely happy at the surprise treat.
Back at the town centre, the team poses for a picture for their final piece. Another artist will take over the mural and paint 3 famous persons portraits on top of this beautiful scenery STIMMA has created.
Above: An artist and historian invites us over to his house. We tour his gallery room and are in awe of all the historical paintings and drawings.
Above: Behind the artist is a custom made grill for the window. It showcases a melody which can be read by any of the music students he teaches. It is a symbol of a music friendly household and his wish is for the melody window to travel on, inspiring others to read and play its tune as you pass by, always knowing where it came from.
Above: Kids showoff their new donated hats and sunglasses.
Above: Back at the clinic, as the afternoon wraps up, we see a lot of patients with depression. A lot of children as i said before are being raised without their parents, for reasons that they’ve passed on or if they work in the city and don’t come home a lot.
Above: The structure being laid out for a new aluminum home being built.
Above: With the reconstruction, you can really see the work we’ve done by the shiny new aluminum metal glowing in the sun.
Above: The team tours the households.
Above: The woman of the household admires her new roof. “It rained and we did not get wet.” This phrase rang deeply amongst our team, many people were coming forward saying this over and over again.
Above: 3 little girls sitting on the lawn in front of their home.
Above: This household’s walls were so poorly broken that thieves had come in through the cracks and stole all their valuables, they were extremely pleased with the new reconstruction and they even built a latrine to guide the rain away from their dwelling.
All the “people from the hill” as we called this community came out to celebrate our last night here in El Salvador, many of them completely emotional at this “miracle” that had come to their neighbourhood.
This mother-to-be has told us that she will be naming her new baby after Lindsay.
DAY 12 . Dress to Impress
Posted on 10 November 2011 | 3 responses
Posted by Angela Lau
The day started again with our construction crew separating with our medical crew. I joined the mobile clinic on a ride on the back of a pickup truck to the little town of Calderitas.
Above: There was a crowd of people waiting for us as we arrived at the school to set up for clinic.
Above: Dagoberto, age 12 and Zoila, age 11.
Above: A lot of the kids’ teeth are rotted.
Above: Many children and babies were present in clinic today.
Above: Movember in El Salvador at its best.
Above: Francisco Javier Martiner, age 77. Francisco came in unlike most other of our patients. His clothes were very dirty and battered, almost always, our patients will dress in their finest clothing to come into the clinic and little do you know, that they’ll go back home to a mud hut and have absolutely nothing to eat. Looks can be very deceiving. Photos do not always tell the whole truth.
Above: Another story about Francisco is that he is still working out in the fields. There is no retirement here, most of these people will be working until they cannot work anymore.
Above: A little girl poses with the new toothbrush and sunglasses we gave her.
The line up did not let up until late afternoon.
Above: This little girl and her sister came to our clinic today. She was extremely upset because she missed her mother. They both lived with their grandmother but their mom would go out for work. They would see her every 15 days for only 3 days at a time because she worked in the city.
Above: Packaging the soup base for distribution.
Above: A grandmother brought two little girls to our clinic just as we had packed everything up. We had to unfortunately turn a few people down at the end of the day but we did tell them our clinic opens again tomorrow in San Esteban Catarina. We took one look at the girl’s sandals and noticed they were too small. We zipped open our flip flop bags and searched hard for sandals that would fit the two girls. There was nothing in their size, they were either too large or too small. It was not our intention to send them away with nothing. Becky took two pairs of larger flip flops, measured their feet and cut them to size. Both girls and grandma walked off extremely happy.
Today we saw a total of 270 patients.
DAY 11 . Stand by me
Posted on 8 November 2011 | 3 responses
Posted by Angela Lau
We’ll call it the never ending line. Today’s patient count added up to 230.
Most of today (and everyday) were patients that needed worm treatment. We did however notice a lot of repeat patients who came into the clinic and having suspiciously changed their stories. We assumed they had wanted to come back to get more donated items, having heard from their friends of what treats they received with what type of story they told. Although it felt slightly uneasy to feel that the people were “scamming” us for more items, I heard more than one person say, “If I were in their position, I would be doing that too.” There is such a dire need for medications, money and food that people will try to do whatever it takes to get more. On a previous mission, I was talking to a little girl who told me that her mother and father had both passed away, I was heartbroken for her story as any one else would be, the next day, the same little girl was in clinic with her mother. I then realized that these kids in need will very quickly learn to say whatever it takes to get through life the best way they know how. We cannot judge people and choose what they need or don’t need but we can show them that there are people that care about them, whoever they are.
Above: The portrait of the most gorgeous woman. She had a polite elegance about her and treated each of our volunteers with a lot of respect.
Above: Pedro and Mary hand out toothbrushes to every patient who came into our clinic. They are very expensive to purchase in El Salvador.
Above: Brenda, age 3 from San Estaban Catarina.
Above: This family consisted of 2 children with cholera and the littlest one in the front is 4 years old and has not presented with any speech capabilities yet. We sent her for psychological testing.
Above: The little one was very scared and nervous at the clinic, hiding her face into her sibling’s laps, but once she saw her picture on the camera, she opened up and started playing peek-a-boo.
Above: I love this skinny little dog that hangs out at the clinic everyday trying to get a free handout. In fact, there are many stray dogs roaming around the town, all cowl in fear of being hit or kicked when you try to reach out to them. There are no vets here so there are many starving dogs walking around with injuries.
Above: Many people will only own one pair of shoes if they are lucky. We only have so many donated shoes of certain sizes, so when we don’t have the right fit for someone, we have to improvise, here Rae is duct-taping an insole into the sandal for a patient who needed more padding on her soles.
Above: Adele packages soup stock (Gleaners) for handouts to patients.
Above: When we hand out reading glasses, we test the patients with eye charts but we also try the “needle and thread” test.
Above: Guillermo and the rest of the interpreters are learning to improve their English from us. Ken has gone the distance and started teaching them about idioms.
Above: Many of the children presented with dental problems. A lot of blackened cavities covered their mouths. This made it all the more important for the education classes we were providing to teach them about the negative effects of drinking cola at such a young age.
Above: This man presented with ring worm.
Above: This woman came into the clinic with the most unique wheelchair. It was created by an Australian group called “Free Wheelchair Mission”
Above: We fitted this little girl with new flip flops which she was extremely proud to receive.
Above: These flip flops belonged to a man back in Kitchener who had recently lost his wife. His wife had a great collection of flip flops which she adored. STIMMA found new homes for each pair.
Above: Our nurse poses with the youngest child of the woman above (with the flip flops). This patient came in right after we had closed the clinic. She told us that she had come from San Lorenzo, a town that was 2 hours away from our clinic. She had heard from a friend about us and hitchhiked all the way to San Estaban Catarina. She told us that she had had 17 children in her lifetime but 7 had passed away for various reasons. The daughter she was with ate hungrily at a granola bar, one of our volunteers gave her. We packed them both home with bags of food and donations.
Above: The little girl has a huge belly due to worms.
Above: Back at homebase, the art school, we are working on another project to revamp the paint on the building.
Tomorrow we are taking the clinic mobile and visiting the town Calderitas. It is a rural town that has gotten no medical attention for quite some time.
DAY 10 . STIMMA blue
Posted on 7 November 2011 | 3 responses
Posted by Angela Lau
Above: After a week of delay, the mural in the town square of San Estaban Catarina is finally touched up with a nice sky blue which we have dubbed STIMMA blue.
Above: René Barahona holding the design for the mural.
Above: Line up waiting for us this morning at the clinic.
Clinic started again today for the second week. We saw a total of 190 patients today. There are 2 new nurses triaging, with Max leading them and showing them the ropes.
Mary, Pedro and Leah, started the education class today.
They used baby powder to demonstrate how germs get passed on from one person to another.
Above: Lois and James pose with a patient and her twins.
Above: Veneta with one of the twins and his new donated sunglasses.
Above: Little girl with clubbed feet, a congenital deformity involving one foot or both. The affected foot appears rotated internally at the ankle. Without treatment, this little girl will appear to walk on her ankles, or on the sides of her feet. It is a common birth defect, occurring in about one in every 1,000 live births.
Above: This woman came in a few days ago to our clinic and was invited back to get new dressing on her wound. An ant had bit her 20 years ago, got infected and had been left untreated for 3 years before she got a skin graft that is now 17 years old. Without the proper treatment for infection and no follow-up in this community, the wound progressively got worse. Rae treated her, while picking away at the infected areas and placed a silver dressing. The silver acts as an antibacterial. The patient also had arterial flow problems which showed in her gnarled toenails and would attribute to a chronic wound if we had left her uneducated. Rae said there’s a saying in the industry that fits very well with this case, “You can see the hole in the person or see the person as a whole.”
Above: Also added to our team this week is Reflexologist, Leah.
Leah did not have a translator available for her while she was with her patients, but she also did not need one. She was able to do her work and read the patients faces, if they winced in pain from the pressure she placed on their feet, she was able to diagnose where the problem areas were occuring.
Above: Adela Antonia Rodriguez, age 86.
One woman had come in complaining about pain in her head and neck. After her visit with Leah, she had also suspected that she had problems with her right ear. The patient was sent back to get it checked and sure enough, there was bleeding inside, an ear infection was the cause.
Above: Thank you to Platinum Drugs for providing prenatal vitamins to our expectant moms.
Above: This man came into our clinic complaining of hemorrhoids. It seemed like an easy case but the man seemed a bit hesistant. He told our nurse Katy, that he had been raped at the age of 15 by several men from his community. He had never told anyone of the doctors before because he was ashamed, but when the hemorrhoids came about, he had been worried that it had been caused by the rape. Katy rest assured him that it had nothing to do with it and they were both very grateful for having to deliver and hear the news.
This family came to our clinic today and told us that they were hungry. A couple was living in the house with their grandson, his mother had gone to the city in search for a job. We toured their home and gave them donated rice, beans, cereal and milk powder.
Above: Lindsay and I went out to the community to access a few more houses today for reconstruction. We have worked and finished a total of 20 houses with 5 more to be completed this week. This man has been helping out with the construction going on in the community. He offered to donate his time and help to reconstruct these houses without pay. We were in awe of his generosity.
Above: This is a photo of a bedroom of a man in the community. It is literally a mattress shielded by an aluminum roof and garbage bags for walls.
Above: This family wants to rebuild this pig pen into a liveable space for their family. We will be working on this reconstruction in the next few days.
Above: The woman of the household is very grateful for what STIMMA has done for them. When we had first arrived to access their homes, a lot of the community members were skeptical that we would come back and actually do what we had promised. Now, they welcome us all lovingly into their homes, ever so grateful for the simple fact that strangers care about them.
Above: The couple from this household seeked us out once they had heard from the community that we were rebuilding houses. We came to access their home. We saw garbage bags for walls, rotten corn for dinner and the couple was also living with 3 young boys. They were extremely grateful when we told them we would be coming early tomorrow with supplies to help them rebuild.
Above: Roberto 9, Asias 7, Mario 3
Back to the clinic.
Above: This patient was getting her assessment when she told the nurse that her husband had passed away just one month ago and she was left at home with 4 children. We sent her home with medications and food.
Above: This man had cancer a while back and had surgery to remove the tumour. He believes it has now come back, his eyes and nose look deformed and he also has another growth on his chest.
Above: Bags filled with various donations, this one is of the sunglasses.
