The morning of the first day of the clinic, and we hadn’t even set it up. We arrived around 7 a.m. — we were supposed to open at 8 — and already at least 100 people had lined up outside the hospital waiting for us.
We’d been told more than once that “in Africa there is no hurry” and today this was maddeningly true … keys had to arrive, meetings had to be held, organizers had to walk through the clinic building and figure out what rooms should be used for what purpose. The rest of us sat outside on benches, in a small shaded area with benches in front of the clinic building, and busied ourselves preparing intake forms and other administrative stuff. I wrote signs in both Swahili and English for the various clinic functions: Admissions, Clinic, Pharmacy, Nutrition/ORT (Oral Rehydration Therapy). Massive suitcases containing donated medications, syringes and first-aid supplies sat unopened. More and more people kept arriving, and it was past 10 by now and the patients were growing less patient by the minute. Finally we got word that we could move into the clinic building.
We began dragging the suitcases indoors. Before we could get them all inside, though, some of the patients waiting in line saw us making the move and a few of them hustled up to the benches we were vacating. This triggered a mad stampede of people running en masse, to claim these valuable spots closest to the door. Some of our staff were afraid they’d be trampled, and really it was a legitimate fear. Lots of needy people, plus foreigners showing up with free health care and drugs, can easily become a recipe for disaster. Lesson number one for this fledgling medical camp: crowd control, right off the bat.
Inside, I stood with a couple other volunteers in the pharmacy room and we unpacked the medications. The shelves filled up with antibiotics, antimalarials, antihistamines, antifungals, dewormers, acetaminophen, ibuprofen, paracetamol, vitamins and lots more. The three Kenyan doctors we’d recruited, plus Casey and the handful of local nurses we’d hired, had begun seeing patients. People started trickling in, handing us their prescriptions even before we’d gotten everything unpacked. Ready or not, we were open for business.
At one point I looked out the pharmacy door and saw Casey in the hall with the old man we’d seen yesterday in the village, the one with the mass on his leg. They were sitting on a bench with a cardiologist named Kenneth, who had flown in from Nairobi to donate his time. It was good to know that at least the man would see a doctor and get that giant lump removed and biopsied, a chance he probably wouldn’t have had without our clinic. Turns out that Casey’s mud-hut diagnosis was spot on; I hoped the guy had just the bone infection, and not cancer. He’d have to wait several days for his biopsy results to come back from Nairobi. At least he’d have an answer. That had to be better than nothing.
As soon as we’d emptied the last suitcase, I beat it out of there to let the local pharmacist and one volunteer get started on the incoming flow of prescriptions. It was about 2 p.m., and after a quick and unsatisfying ham sandwich, was time for me to help with the outreach part of the clinic: going to schools for deworming.
I walked with Rennatus, Serena, Laura, and Ferdinand to a nearby public school. We had a big bottle of deworming pills with us, enough for the thousand or so kids from first through eighth grade. Each child had to take a tablet to kill internal parasites, and most of these kids surely harbored at least one of the main types of parasites so common in the area: schistosomes, helminths, pinworms, hookworms, tapeworms, whipworms and more.
The school was a series of frankly dirty cement rooms in the middle of well-trimmed and lush grounds, a battered Kenyan flag flapping on a pole. We went first to the office of the headmaster to introduce ourselves. Rennatus had sent word of our mission through a teacher, but the headmaster hadn’t gotten the message, or maybe he had forgotten. Either way, he seemed glad to see us, and agreed to set up a couple of tables outside for us with pitchers of water and communal cups; yes, communal cups. Not the most hygienic of situations by a long shot, but 1000 disposable Dixie cups were rather out of the question here.
The teachers let their students out of the classrooms grade by grade, and they ran over to our tables, yelling and shouting, a manic sea of faded and well-worn blue uniforms. Most of them had spotted us out the window, and they reacted to us in much the same way the kids in the village had. It took all the teachers’ efforts to get them lined up in some semblance of order so they wouldn’t mob us.
All we had to do was stand there with surgical gloves on (for sanitary purposes, though that seemed rather moot, what with 1000 of them sharing six cups) and dole out the pills, child by child. Three seventh-grade girls appointed themselves my water helpers, taking turns filling the communal cups and giving them to each kid who received a pill. I greeted every kid in line with some basic Swahili phrases I’d memorized: hello, how are you?, what’s your name? and, after they swallowed the rather large and bitter pill: good job!
The whole situation seemed surreal to me. Not just the rockstar treatment that came our way, but the fact that none of their parents knew we’d be here today, medicating their children. We’d been told the deworming pills had no ill effects; that this type of treatment was necessary and potentially lifesaving in this area; that infected kids would pass the dead parasites over the next couple days; that nothing adverse would happen to kids with no parasites.
But I still felt as though we were committing a fundamental wrong. In the U.S., and many other cultures, it would not be okay at all for strangers to show up and dispense pills to an entire student body without parental consent, no matter how well-intentioned. The headmaster and teachers acted like it was just fine, though, and I had to remind myself that I was working within their culture and not the other way around. I tried to see the situation through the children’s eyes: lining up in the schoolyard so the mzungu lady in rubber gloves can hand you a pill to swallow. That had to be surreal for them, too.
By the time we got back to the clinic, crowd control was under way, in the form of a lottery system and a larger-than-life local volunteer named Mishat with an affable personality and booming James Earl Jones voice. Everyone had received a numbered ticket, and Mishat passed through the crowd, identifying those who needed to be seen right away and arranging for their number to be called next. It took another hour for the day’s patients to move through the system, and we headed home at around 6 p.m. Dark was falling and the rest of the staff looked as tired and worn out as I felt. As we walked down the main dirt road of Port Victoria, I saw a bright and colorful spot bouncing in the air: the kids from yesterday, still playing with the beach ball we’d brought. Next year, I thought: 1000 beach balls. At least.
