Day 12: Monday, January 23, 2006
Today was a long, but eventful day as we experienced African time more than once! The team was ready to leave for Maua at 8:00 a.m. this morning in order to be at the hospital by 9:30, but the van was not present. After calling at 9:00 to inquire as to what was happening, we learned that the van had a flat tire that had a puncture and was being repaired. We sat back down and waited for things to get done and did not leave until 9:45. Once we were on the road, we began thinking that things would now move smoother as we enjoyed the scenery.
We were then stopped by one of the policeman at one of several checks. He wanted to give our driver a ticket because one of the stickers was out (there are about 5 on the windshield. Had Stephen not been along to explain to the policeman that they had taken the van for inspection but the place of inspection was out of stickers and they were told to come back, the driver would probably have received the ticket. (Now you figure this one out, the sticker had expired several months ago – not just last month . . .) We also learned that this was the spot in the road where Stephen’s wife was often asked for tea as she commuted back and forth to work when she was here. “Tea” in this sense was not tea to drink – but was instead some money (a bribe) in order to avoid being ticketed for something.
We made our way along thinking that we were now fine only to start smelling – and seeing – smoke coming forth from around the stick shift. We stopped the van along the side of the road as the smoke continued to come forth and evacuated the van. John and Alfred quickly discovered that the problem was that a water line had come loose (and the van was out of water just as the light had indicated – but that we were told to “not worry” about). There was a retired school teacher, Joyce, sitting on the side of the road that we approached. She told us that she ran a canteen across the street and was waiting for someone. She gave us some water and then offered to take us to the primary school whose entrance was just a few steps away from the broken down van. We were eager to see the school as we left John and Alfred working with Moses on the van (while Stephen had meanwhile called the hospital to send a van when we were not sure what was going on AND had called Ravena to come for back-up just in case as well).
Making our way down to the school, we saw a few children coming out of their classrooms for recess as we greeted the headmaster (whom Joyce had taught as a student) and made our way into one of the classrooms. The classroom had a dirt floor and bench type seating where there were typically 3 students to a desk. There were a total of 46 students and one teacher in the Standard 8 (8th grade). We stayed only a few minutes before heading back outside, followed by the students shortly thereafter. Meanwhile more students (a total of 530) had been gathering outside and the headmaster was lining them up. Once all of the students were in place, they sang the national anthem for us in Swahili, and then they were “released” and we mingled with them. They were quite curious about us with our white skin moving about with them and shaking their hands. After a short while, we were told that the van was repaired (thanks to John and his handy pocket tool working along with Moses and Alfred). So, we were on our way again and did not have another opportunity to delay our arrival at the Methodist Hospital in Maua and were greeted by Stanley (whom some of the team knew from his school days in Oklahoma).
The 254 bed facility was sparse by American standards but one of the best facilities in Kenya. Upon arrival we had tea and then did a quick tour. Then, we were served lunch (rice, stew, chapattis, fruit, and sodas). As we walked the facility, we were told and observed many things. From the operational aspect, we learned that the hospital:
Has one of the most active programs for HIV, VCT (testing for Aids), and treatment of Aids patients in Kenya thanks to a grant provided by the United States to provide medication. They are very grateful to President Bush and what has been able to be accomplished for Kenyans through this grant money.
The hospital offers support groups for guardians of 200 – 250 of over 1000 orphaned children whose parents have died from Aids.
Every staff contributes 5% of their salary for HIV insurance.
The hospital works with the churches in the area to provide support in an attempt to help take care of the adults so that the adults can continue to live and not leave their children orphaned.
The cost of the treatment that is available for AIDS in Kenya is 9000 Schillings a month (when the average non-skilled laborer makes about 100 Schillings a day (and a skilled laborer not a lot more!).
The grant money is for a 5-year period; they are at a loss as to what will happen after the grant money has expired and Bush leaves office.
The grant money can treat only about 600 in the community; this is estimated to be about 30% of the people that actually need it.
Several homes have been built for orphaned children; a typical home that is 12’ x 24’ costs 130,000 Schillings ($__).
Clinics are offered for surgical, medical, obstetrical, and palliative care.
The patients, not the staff wear scrubs (deep blue ones); the staff wear regular clothing. This helps to identify the patients when they are out of their bed. It also helps to identify staff prior to their departure!
Many patients stay in the hospital longer than is required simply because they have no one to come and pay the bill for them. As one enters the hospital compound, there is a double gate with the registration / check-in / check-out area located between the two gates. Upon leaving, one is supposed to pay before proceeding out of the second gate. However, this has still not solved all of the problems; sometimes, family members will sneak clothing into the hospital for the patient to change into (I’m not sure how this is accomplished given the lack of privacy that I observed) and then just walk out. Often mothers stay for several days, or even weeks, instead of the 1 – 3 days common in the States because of their inability to pay.
The facility has a Mobilization / Equipping / Training program in which youth are trained for 5 days. They then go out into the villages and try to reach people from the ages of 10 to 30 giving them information about “abstinence and fit-fullness”.
The hospital has a van that is used for an ambulance. Often people are brought to the hospital via public transportation or are carried.
There is a house / cottage on site for visiting physicians who want to come and work in the hospital for a while.
The facility has tripled in growth of built area since 1980.
From a physical-plant standpoint, we observed and/or were told:
There are 254 beds of which the majority are in a ward environment.
A typical ward consists of 30 beds that are sub-divided into pods of 10 beds. A typical patient area consists of a bed and a nightstand; the adjacent bed is within arm’s reach. There are some cubicle curtains which may be drawn only in a patient exam or procedure environment. There is not an abundance of electrical outlets or medical gases or things to hang an IV on (we did not see any electrical outlets on the typical headwall and there might be one location for every 3 beds to connect a regulator).
There are a total of 71 designated labor and postpartum beds (there are no LDR’s or LDRP’s here) with 2 nurseries (each can hold up to 16 infants) and 18 nurses.
There are 51 bays for Surgical Recovery with 10 beds in the “Advanced Unit” (similar to our Critical Care Unit).
The Medical Ward has 30 beds for males and 30 beds for females.
The Children’s Ward has 62 beds.
Patients needing Isolation (including TB patients) are currently mixed in with the general patient population; however, in the children’s ward, there are a couple of private rooms. In order to address this need, there is a new building being constructed which will have 40 private rooms for patients requiring isolation. There will not, however, be any special ventilation / HVAC system to address the air filtration. Each room will have a window. This is being funded by a donation from a group in the Netherlands.
In the children’s ward, mothers were there with their children trying to feed and/or comfort them. They shared the same bed as the child.
Imaging consists of 2 pieces of equipment in a single room: a general unit with a chest bucky on one side of the room and an ultrasound machine on the other side of the room.
Within Surgery, there are 4 Operating Rooms (called “theaters” after the British model here). Two of them are from major procedures; 2 are from minor care (and one of these is used for c-section deliveries).
The facility accommodated 2400 births last year; they have accommodated up to 3000 previously. There is no LDR concept. They do have labor wards and a couple of delivery rooms and then a postpartum ward for the moms and 2 nurseries for the infants.
Emergency consists of 2 couches; however, they are wanting to build a “Trauma Center”.
The Laundry consists of 3 large washers and 1 large dryer (commercial size for all). However,
The dryer does not work and is locked into place so that it is taken away. The blankets are not washed in the washers; instead, they are washed in concrete sinks in an adjacent room. Drying generally occurs on the lines for sheets but on the grass for other items.
There are no facilities provided for endoscopy, bronchoscopy, cardiac cath, angio, CT, MRI, etc.
There is a place for burial of bodies for those who die in the care of the hospital and are not claimed; this is located behind the hospital near the mortuary. We were told that typically those who are left behind are single adults who are not married and do not have children because they are considered “worthless” by “society”.
After we left the hospital, we drove back to Meru with no complications and visited the School for the Mentally Handicapped as a group (not just Jack, John, and Kellye) to see the facility and discuss / present a solution to the water line problem.
The children who are accommodated here generally have Down’s Syndrome, autism, epilepsy, and/or dyslexia. (The latter two really surprised us.)
Children are housed in dorms consisting of 30 beds per dorm (i.e. one large open space) and a house mother who also has a cot in the large room. Some, but not all, have mosquito netting that may be used.
There are 2 dorms for girls and 2 for boys. There is a need for more beds.
We were able to tour some of the classes and see the children being taught different skills.
They have a workshop which provides vocational training (carpentry, jewelry making, and some sewing skills) for both boys and girls once they are older.
There was a group of children who sang and danced for us. They recited, “I can do all things through Him that strengthens me.” They also sang a song welcoming the “mwanambei” who has come to help them; the words translated into something like this:“A wonderful son or daughter visiting them coming with many things. For example, milk, millet, maize, goats, chicken, etc.”
The school was started in 1970 and moved to its current location in 1982. They have grown from 9 students in 1970 to 110 students today; staff has increased from 2 teachers to 17 teachers plus 21 support staff.
The school raises some maize, watermelon, and cows. They also have a mill to grind the maize into flour.
Support staff and materials are provided through government funding.
There is a long waiting list; however, they do not have sufficient classroom space or dorm beds now to accommodate more children.
VIM agreed to work through the Mubichi Foundation to leave enough money now to buy the land for the intake and get an intake built. Then, the VIM team will return to Oklahoma and work with them to try and get the water in place as soon as possible with additional funding.
The VIM team was thanked and asked to consider helping with 2 other projects: (1) providing at least 4 new classrooms, and (2) creating a home science project.
The children and staff were invited to use the new library at the School for the Deaf.
It was clear that the teachers had a love for and patience with the children; likewise, the children appeared to care for the staff about them and were happy to have visitors.
Gifts were provided for the churches represented.
Once we were finished with tea, the tour, the speaking aspects, and the exchange of gifts, we went back to the hotel for supper. Tonight, we had samosas (vegetarian and meat), beef stew, rice, mashed potatoes (this one had maize, peas, and greens in it), and fruit salad with ice cream for desert. After dinner, we met briefly for devotions and to discuss logistics for the next phase of the trip. We then disbursed so that people could pack their bags for an early morning departure.
Submitted by Kellye J
We were then stopped by one of the policeman at one of several checks. He wanted to give our driver a ticket because one of the stickers was out (there are about 5 on the windshield. Had Stephen not been along to explain to the policeman that they had taken the van for inspection but the place of inspection was out of stickers and they were told to come back, the driver would probably have received the ticket. (Now you figure this one out, the sticker had expired several months ago – not just last month . . .) We also learned that this was the spot in the road where Stephen’s wife was often asked for tea as she commuted back and forth to work when she was here. “Tea” in this sense was not tea to drink – but was instead some money (a bribe) in order to avoid being ticketed for something.
We made our way along thinking that we were now fine only to start smelling – and seeing – smoke coming forth from around the stick shift. We stopped the van along the side of the road as the smoke continued to come forth and evacuated the van. John and Alfred quickly discovered that the problem was that a water line had come loose (and the van was out of water just as the light had indicated – but that we were told to “not worry” about). There was a retired school teacher, Joyce, sitting on the side of the road that we approached. She told us that she ran a canteen across the street and was waiting for someone. She gave us some water and then offered to take us to the primary school whose entrance was just a few steps away from the broken down van. We were eager to see the school as we left John and Alfred working with Moses on the van (while Stephen had meanwhile called the hospital to send a van when we were not sure what was going on AND had called Ravena to come for back-up just in case as well).
Making our way down to the school, we saw a few children coming out of their classrooms for recess as we greeted the headmaster (whom Joyce had taught as a student) and made our way into one of the classrooms. The classroom had a dirt floor and bench type seating where there were typically 3 students to a desk. There were a total of 46 students and one teacher in the Standard 8 (8th grade). We stayed only a few minutes before heading back outside, followed by the students shortly thereafter. Meanwhile more students (a total of 530) had been gathering outside and the headmaster was lining them up. Once all of the students were in place, they sang the national anthem for us in Swahili, and then they were “released” and we mingled with them. They were quite curious about us with our white skin moving about with them and shaking their hands. After a short while, we were told that the van was repaired (thanks to John and his handy pocket tool working along with Moses and Alfred). So, we were on our way again and did not have another opportunity to delay our arrival at the Methodist Hospital in Maua and were greeted by Stanley (whom some of the team knew from his school days in Oklahoma).
The 254 bed facility was sparse by American standards but one of the best facilities in Kenya. Upon arrival we had tea and then did a quick tour. Then, we were served lunch (rice, stew, chapattis, fruit, and sodas). As we walked the facility, we were told and observed many things. From the operational aspect, we learned that the hospital:
Has one of the most active programs for HIV, VCT (testing for Aids), and treatment of Aids patients in Kenya thanks to a grant provided by the United States to provide medication. They are very grateful to President Bush and what has been able to be accomplished for Kenyans through this grant money.
The hospital offers support groups for guardians of 200 – 250 of over 1000 orphaned children whose parents have died from Aids.
Every staff contributes 5% of their salary for HIV insurance.
The hospital works with the churches in the area to provide support in an attempt to help take care of the adults so that the adults can continue to live and not leave their children orphaned.
The cost of the treatment that is available for AIDS in Kenya is 9000 Schillings a month (when the average non-skilled laborer makes about 100 Schillings a day (and a skilled laborer not a lot more!).
The grant money is for a 5-year period; they are at a loss as to what will happen after the grant money has expired and Bush leaves office.
The grant money can treat only about 600 in the community; this is estimated to be about 30% of the people that actually need it.
Several homes have been built for orphaned children; a typical home that is 12’ x 24’ costs 130,000 Schillings ($__).
Clinics are offered for surgical, medical, obstetrical, and palliative care.
The patients, not the staff wear scrubs (deep blue ones); the staff wear regular clothing. This helps to identify the patients when they are out of their bed. It also helps to identify staff prior to their departure!
Many patients stay in the hospital longer than is required simply because they have no one to come and pay the bill for them. As one enters the hospital compound, there is a double gate with the registration / check-in / check-out area located between the two gates. Upon leaving, one is supposed to pay before proceeding out of the second gate. However, this has still not solved all of the problems; sometimes, family members will sneak clothing into the hospital for the patient to change into (I’m not sure how this is accomplished given the lack of privacy that I observed) and then just walk out. Often mothers stay for several days, or even weeks, instead of the 1 – 3 days common in the States because of their inability to pay.
The facility has a Mobilization / Equipping / Training program in which youth are trained for 5 days. They then go out into the villages and try to reach people from the ages of 10 to 30 giving them information about “abstinence and fit-fullness”.
The hospital has a van that is used for an ambulance. Often people are brought to the hospital via public transportation or are carried.
There is a house / cottage on site for visiting physicians who want to come and work in the hospital for a while.
The facility has tripled in growth of built area since 1980.
From a physical-plant standpoint, we observed and/or were told:
There are 254 beds of which the majority are in a ward environment.
A typical ward consists of 30 beds that are sub-divided into pods of 10 beds. A typical patient area consists of a bed and a nightstand; the adjacent bed is within arm’s reach. There are some cubicle curtains which may be drawn only in a patient exam or procedure environment. There is not an abundance of electrical outlets or medical gases or things to hang an IV on (we did not see any electrical outlets on the typical headwall and there might be one location for every 3 beds to connect a regulator).
There are a total of 71 designated labor and postpartum beds (there are no LDR’s or LDRP’s here) with 2 nurseries (each can hold up to 16 infants) and 18 nurses.
There are 51 bays for Surgical Recovery with 10 beds in the “Advanced Unit” (similar to our Critical Care Unit).
The Medical Ward has 30 beds for males and 30 beds for females.
The Children’s Ward has 62 beds.
Patients needing Isolation (including TB patients) are currently mixed in with the general patient population; however, in the children’s ward, there are a couple of private rooms. In order to address this need, there is a new building being constructed which will have 40 private rooms for patients requiring isolation. There will not, however, be any special ventilation / HVAC system to address the air filtration. Each room will have a window. This is being funded by a donation from a group in the Netherlands.
In the children’s ward, mothers were there with their children trying to feed and/or comfort them. They shared the same bed as the child.
Imaging consists of 2 pieces of equipment in a single room: a general unit with a chest bucky on one side of the room and an ultrasound machine on the other side of the room.
Within Surgery, there are 4 Operating Rooms (called “theaters” after the British model here). Two of them are from major procedures; 2 are from minor care (and one of these is used for c-section deliveries).
The facility accommodated 2400 births last year; they have accommodated up to 3000 previously. There is no LDR concept. They do have labor wards and a couple of delivery rooms and then a postpartum ward for the moms and 2 nurseries for the infants.
Emergency consists of 2 couches; however, they are wanting to build a “Trauma Center”.
The Laundry consists of 3 large washers and 1 large dryer (commercial size for all). However,
The dryer does not work and is locked into place so that it is taken away. The blankets are not washed in the washers; instead, they are washed in concrete sinks in an adjacent room. Drying generally occurs on the lines for sheets but on the grass for other items.
There are no facilities provided for endoscopy, bronchoscopy, cardiac cath, angio, CT, MRI, etc.
There is a place for burial of bodies for those who die in the care of the hospital and are not claimed; this is located behind the hospital near the mortuary. We were told that typically those who are left behind are single adults who are not married and do not have children because they are considered “worthless” by “society”.
After we left the hospital, we drove back to Meru with no complications and visited the School for the Mentally Handicapped as a group (not just Jack, John, and Kellye) to see the facility and discuss / present a solution to the water line problem.
The children who are accommodated here generally have Down’s Syndrome, autism, epilepsy, and/or dyslexia. (The latter two really surprised us.)
Children are housed in dorms consisting of 30 beds per dorm (i.e. one large open space) and a house mother who also has a cot in the large room. Some, but not all, have mosquito netting that may be used.
There are 2 dorms for girls and 2 for boys. There is a need for more beds.
We were able to tour some of the classes and see the children being taught different skills.
They have a workshop which provides vocational training (carpentry, jewelry making, and some sewing skills) for both boys and girls once they are older.
There was a group of children who sang and danced for us. They recited, “I can do all things through Him that strengthens me.” They also sang a song welcoming the “mwanambei” who has come to help them; the words translated into something like this:“A wonderful son or daughter visiting them coming with many things. For example, milk, millet, maize, goats, chicken, etc.”
The school was started in 1970 and moved to its current location in 1982. They have grown from 9 students in 1970 to 110 students today; staff has increased from 2 teachers to 17 teachers plus 21 support staff.
The school raises some maize, watermelon, and cows. They also have a mill to grind the maize into flour.
Support staff and materials are provided through government funding.
There is a long waiting list; however, they do not have sufficient classroom space or dorm beds now to accommodate more children.
VIM agreed to work through the Mubichi Foundation to leave enough money now to buy the land for the intake and get an intake built. Then, the VIM team will return to Oklahoma and work with them to try and get the water in place as soon as possible with additional funding.
The VIM team was thanked and asked to consider helping with 2 other projects: (1) providing at least 4 new classrooms, and (2) creating a home science project.
The children and staff were invited to use the new library at the School for the Deaf.
It was clear that the teachers had a love for and patience with the children; likewise, the children appeared to care for the staff about them and were happy to have visitors.
Gifts were provided for the churches represented.
Once we were finished with tea, the tour, the speaking aspects, and the exchange of gifts, we went back to the hotel for supper. Tonight, we had samosas (vegetarian and meat), beef stew, rice, mashed potatoes (this one had maize, peas, and greens in it), and fruit salad with ice cream for desert. After dinner, we met briefly for devotions and to discuss logistics for the next phase of the trip. We then disbursed so that people could pack their bags for an early morning departure.
Submitted by Kellye J
posted by Jean Warner at 11:45 PM
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