The next couple of days in the clinic went much the same as the first, except the number of patients increased with every day. Word was spreading around the region that there were mzungu doctors at the Port Victoria hospital, and they were giving away free medications. People showed up who appeared healthy but claimed to be sick; some mothers brought all their children, saying vaguely that they thought they might all have malaria. You couldn’t blame them for wanting to stock up; if they weren’t sick now, they would be at some point, without this kind of access to medications or nutritional supplements. The doctors inevitably prescribed something — vitamins, Advil, folic acid — just to make sure people were walking out of the pharmacy with something useful. So many of them wanted to see the lone mzungu doctor Casey, who’s still in med school, that some patients came back and waited in line again, after they’d already seen a Kenyan doctor, just so they could have an appointment with him.
One thing the doctors prescribed a good deal was Oral Rehydration Therapy, to anyone with diarrhea and to all sick babies and children. It’s just a simple mixture of salt and sugar — the salt to replace lost sodium, the sugar to ensure its absorption in the intestines. But it saves lives all over the developing world, where diarrhea (and associated dehydration) is the second biggest cause of death among children under 5.
The pharmacy had packets of oral rehydration salts, the kind found in all travel med kits, that they doled out until they ran out. Dani had written and illustrated a bunch of leaflets in English and Swahili, with instructions on how to mix oral rehydration solution. We dragged a table outside to where people were clustered around the pharmacy window waiting for their prescriptions. There, with the help of a translator, she did ORT demonstrations and passed out the leaflets. When people received prescriptions for ORT after the packets were gone, Danielle would meet with them in the Nutrition/ORT office for a one-on-one testimonial, and to give them sugar and salt. I’d bet anything that several Kenyan kids will, over the years, owe their lives to Dani.
I went to two more schools to dispense deworming pills, hiking for 3 hours down dirt roads and smaller dirt paths, through mud-hut villages, before we arrived at the remote schools. The uniforms were more worn, the buildings more run-down, the teachers more likely to carry thin reed sticks with which they would swat errant kids into place. They had the same reaction to seeing mzungu as the children in the first school. This time I remembered to dispense pills with my sunglasses off. I’d learned in other countries that people who’ve never met Caucasians before are especially interested in seeing blue and green eye color. It is disconcerting to have person after person after person staring at your eyes, but I did make eye contact with every child, and I was glad for that. The clinic organizers had recommended that we volunteers deworm ourselves before leaving this area where parasites were so prevalent. So at one school I demonstrated taking the pill for a couple hundred children, brandishing the big tablet with a flourish before washing it down with water.
When we got back from the hike that afternoon, after giving away thousands of deworming pills, I arrived to find more people than ever gathered outside the pharmacy. With a growing stream of patients and one harried pharmacist being assisted by just one volunteer (Megan, who wasn’t a pharmacy tech), we had a serious bottleneck. One of the other volunteers, Laura, and I squeezed into the small pharmacy room to help. The pharmacist would read the prescription from the growing stack in front of him, scribble the drug and dosage onto a small Ziploc bag, and one of us would locate the medication and count out the pills. We stayed in that office until after the sun went down. The building electricity never came on and the hospital groundskeeper had to wedge in there holding a flashlight so we could see to count. We worked like this until all the day’s prescriptions were filled. We took prescriptions written by non-clinic doctors, too, if we had the right meds. We dispensed drugs and supplies for a huge variety of injuries and illnesses (especially malaria); we saw people of all ages, including a baby named Barrack Obama. I admit I threw more vitamins, Advils, Tylenols and Pepcids into the bags than were prescribed. I knew they wouldn’t go to waste.