January 8-29, 2015
A group of 23 volunteers representing RVUCOM and Hands for Health, NFP traveled to Kenya to provide primary health care to people living in the Kimana district, just north of the Tanzania border and Mt. Kilimanjaro. 10 third year and 6 forth year RVU medical students were accompanied by 2 faculty and other health care professionals. The RVU faculty that participated in the trip included Dr. Camille Bentley (director) and Dr. Jill Pitcher along with Dr. Douglass Crawford, Barbara Crawford, RN, Dr. Angela Giampaolo and 2 Community Volunteers There was another group representing Dream Weaver International which consisted of 3 Chiropractors and 6 Community Volunteers, which accompanied us for most of the trip.
We were guests of Dr. Scott Smith and Heidi Smith, RN who travel there a few times every year to provide health care to the local people living in this remote part of the country. Peter “Amos” Ngare is the local health care worker that establishes and sets up the actual daily work sites for us. They have purchased land, and have recently broken ground for a clinic, which is expected to be completed in the next 2-5 years.
The group worked 14 days, traveling to 14 small villages, and provided care for approx. 1500 patients. Travel times varied from 30 minutes to 2 hours each way. We travelled by bus and a TATA. The sites did not have any electricity, running water or bathrooms. Conditions were quite austere, working by sunlight. Days were very hot, in the low 90’s, and dusty. Everyone had to carry their own food and water, set up tents to work in. We carried the well-stocked pharmacy from site to site daily. We did bring 5 duffels of supplies and meds, which were left behind for extended use after our departure. Starting with the next trip, we will not bring any meds into the country; instead all meds will be purchased there by the Smiths prior to our arrival. This is because of new harsher local District Director of Health regulations just put into place. We will continue to bring in Note forms, a scale, clip boards, tape measures, automatic BP cuffs and thermometer for group use.
Every day 2 students rotated through the pharmacy and the triage area, leaving the other 12 students available to see the approx. 1500 patients. We had 8-10 local volunteers working with us as translators daily for the entire 15 days. Everyday involved a set up and breakdown, which usually could be accomplished in less than 30 minutes due to the great cooperation of ALL the volunteers. The towns visited were: Iremito, Emparingoi, Enkaroni, Ilkangere, Enkii, Mardana, Empiron, Meshanani, Ottomalo, Oltapari, Lemongo, Kalesirwa, and Kimanax2. 90% of the patients were Masai, living in and around Amboselli National Park, so most days afforded “Being on safari” while commuting to and from work.
While demonstrating professionalism, respect and enthusiasm, students were able to practice and hone the following skills:
Taking an appropriate History and performing a Physical Exam
Excellent Patient rapport and Cultural sensitivity
Ability to work with a translator
Ability to work as part of a team
Performance of OPP
Take vitals
Prescribe and deliver culturally appropriate medications
Formal Presentation of each and every case
Discussion of differentials, assessment and plans with their preceptors
There was a definite difference between the levels of competency between the 2 classes, allowing the seniors to mentor the 3rd years.
Due to the high incidence of worm infections in the children and under the direction of “Amos” volunteers from our group also dewormed almost 2000 children. There were many cases of skin and respiratory infection, malnutrition and trauma attended to by the students.
The group stayed at “Kibo Slopes Cottages” located about 1 hour from the sites, as oasis in the midst of this very rural landscape, providing us with hot water for showers and a good breakfast and hot dinner daily. Once again, The SAT phone provided through RVU did not work well, due to the cloudy weather. We will most likely not use this phone in the future. Instead we used a local cell phone purchased last year, with minutes for $25.00. The phone was used by anyone who needed to call home. Due to lack of email access, we also purchased form one of the volunteers use of her “Hot Spot” and about 8GB of data for $50.00. I will purchase when for use by the group in the future. On our last night, Kibo slopes prepared for us a barbeque party, with Maasai song and dance. This ended the trip on a festive note for everyone.
In the middle of the work days, the group ventured to Arusha, a city in Tanzania for a day of R&R. Despite the heavy rain, students everyone was able to get some much needed rest. The hotel, Ilboru Safari Lodge was a good oasis in the hustling bustling town. We will probably not return to Arusha in the future, but rather stay in Kenya, and seek some down time at one of the stellar safari resorts adjacent to one of the parks.
The trip was budgeted at $2000 each, and we actually spent about $1750 per person, which gives us a surplus in the outreach fund of about $4000.
Overall, this was an excellent trip and great medical learning and personal growth experience for the students. Major change for next year will be devoting an entire day at the beginning and the end for orientations, meet and greets, debriefing and retrospection. These were too rushed or non- existent on this trip. This will also give the entire group a chance to adjust to their new environment and have time to pack in an organized fashion at the end.
We look forward (as well as those there) to our return in January of 2016.
Camille Bentley, DO
Chair, Global and Community Medicine and Director, Kenya Medical Outreach
President, Hands for Health, NFP