It was a Wow Wednesday

Just when we thought we’d seen all there was to see here at AMPATH, we were once again reminded of how narrow our perspective can be.  Today started out within my range of comprehension; I got to go back to the laboratories and talk with the Quality Management team (think QA for QC all you Lilly Q folks).  We had a very engaging discussion and they were quite surprised to learn that I speak their language.  One of their first questions to me was if I thought we could help them define a Quality Management System for their labs…of course I didn’t make any formal commitments but you could see the relief on their faces when I started sharing with them the components of the Quality System that we have defined for our laboratories.  They also said they struggled to getting to a “real root cause” when they had non-conformance investigations….at that point I could have pinched myself….I assured them we have some of those very same challenges and we could probably share some our learnings with them.  It was smooth sailing after that and I came away from the meeting totally pumped.

After my meeting in the labs I met up with the rest of the team and we headed to the Mental Health Clinic that was being held today in MTRHospital.  There was a very soft spoken, well-versed psychiatrist who explained to us how the clinics work both there in the hospital and also in some of the satellite clinics.  We got into some discussions about the stigma associated with mental illness and asked if he felt it was similar to what we saw in the US.  He grinned at his associate, nodded his head, and said follow me, I want to show you the mental health ward.  As we headed out of the building he told us the stigma was very prevalent, even among other physicians as well as among the general population.  We followed him to what looked like a horse corral surrounded by a high wooden fence next to a concrete bunkhouse with a sign on the entry gate that said “Kenya Ward”.  I won’t post any pictures in deference to the patients and their families but I can tell you that everyone on the team was so taken aback by what we saw that we were nearly speechless.  Even within the hospital setting, this ward was clearly set apart and the patients treated with a very different level of respect than the HIV patients who have also had to fight off a certain level of stigmatization.  The doctor certainly knew what he was doing in actually taking us into the area, which consisted of a large open air dirt arena surrounded on two sides with the wooden fence and the other two sides made up by two buildings.  One building was a dormitory building that looked like something out of the holocaust and another open-faced building that served as the dining area and/or recreation facility.  He knew that once we had seen this first hand we would have to share what we’d seen and hopefully be able to help the hospital find a way to move forward with a new facility.  It was quite literally heart-wrenching and gut-wrenching all at the same time.

It took us a bit of time to recover from what we had seen and fortunately in the afternoon we were able to move across the emotional spectrum and visit a place filled with hope and compassion, the Sally Test Pediatric Center.  We had heard “Sally Test” mentioned several times throughout the week and knew it must be something special and were glad that we were finally getting a chance to see it firsthand.  The Sally Test center is a combination recreation/education/nurturing area where kids from the hospital wards that are well enough to leave their rooms for a period of time can come to play games, be read stories to, have some computer time, and even go outside and play on some playground equipment.  We also learned that it is a place for the hospital to take in abandoned or orphaned children to care for them 24/7 until they can find a permanent home or facility to take them.  While we were there we saw an infant girl who is HIV positive and was orphaned when her mother, a child of the street, died of complications from HIV.  Another little boy about 5 or 6 years old who has some special physical and emotional needs was abandoned and brought to Sally Test a few months ago.  The director and staff of the center are working with other resources in the community to try and find a more permanent home for him.  In the meatime, they love him and care for him as if he were one of their own.

While we were there a group of children from the orthopedic wing came into the center in their green hospital clothes and sat down at the table to play a spirited game of Go Fish…it was humbling to see the joy in their eyes that they felt by being able to get out of their “sick place” and come into a safe and loving place even if only for a little while during the day.  Needless to say, our hearts and our sprits lifted dramatically after spending time with the staff and the children there.  This is a unique and wonderful resource that runs on a shoe-string budget and relies heavily on volunteers and donations to make it what it is today and to keep it going for the future.

We left the Sally Test center and actually left the AMPATH grounds for the remainder of the day.  It was time for another driving adventure as we headed across town to the other side of Eldoret to visit the Imani workshops.  This is a place where HIV positive patients and/or former patients are employed as craftsmen and artisans.  There are 5 main workshops within the building.  The first one we visited was the textile area where they make clothing, purses, aprons, stuffed animals and many things in between.  The second area we visited made beads out of strips of magazines….try to imagine the pages of a magazine being cut into long skinny triangles about ½ to 1 inch wide depending upon the size of the bead and going the entire length of the page.  The strips are laid out on a board and covered with a shellac-like substance and then rolled up tightly starting from the “fat” end and rolling to the point of the triangle.  They are then dried and voila – you have a bead to string on a necklace, bracelet, belt, whatever you might imagine – truly ingenious and their raw material expense is practically nill. 

The third area we visited was the ceramics and pottery area.  We were taken outside and shown where they actually make their own clay.  They start out by pulverizing the clay/dirt by hand, sift it and then soak it in a vat of water and other chemicals for 3-4 weeks.  After that they remove it and strain it on an old bed sheet and then bag it up until they are ready to use it.  They use the clay to make everything from hand-rolled beads to sculptures to pots.  They have a gas-powered kiln where they fire the pieces and then they take them inside for glazing and finish work.  The fourth area we visited was the art center.  Artists paint all sizes of works on canvas or paper or whatever other media might be available.  They paint some stock pictures and also do custom orders.  All of the artwork on the walls of the Riley Mother and Baby hospital was painted by these artists.

The last workshop we visited was the paper-making area.  They make two kinds of paper here – recycled paper from “shredded” forms and documents from the hospital and papyrus paper.  They showed us how they pulverize the paper shreds (by hand) and for the papyrus they cut it into small pieces and boil it until it looks like floating saw dust.  They use these pulp bases to screen out onto cloths and press them and dry them and make pages of paper.  Sometimes they dye them to beautiful green or blue or pink hues.  They make everything from journals, to pressed paper picture frames or boxes, to wedding invitations to papyrus bowls and even paper mache animals and masks.  Of course all of these items were on sale in the gift shop and needless to say, we helped support their cause before we left the premises!  This workshop is a way for people who have worked with the doctors to gain control of their disease to now focus on other areas of their life, most notably gaining an income.  The things they make are very beautiful and its truly amazing to see how creative and frugal they are with the raw materials that are available to them.  It was also wonderful to see the pride gleaming from their faces as they showed what they were capable of making.

The people behind the efforts of the Imani Workshop and the Sally Test Pediatric Center truly have a heart for making a difference in the lives of the patients and want to make sure they have every chance to live a productive and happy life.  I’ve been able to spend some time with a few of these very special leaders and they are some of the most humble and modest people you will meet…God has given them a gift and they are using it to do what they can to give hope to those who need it most.

Once we left Imani workshop we had to head back into town to visit the Kenyan version of “Walmart”, known as Nakumatt.  We picked up some more bottled water and other refreshments, some t-shirts, and a much needed hat for the upcoming safari trip.  The streets of Eldoret are quite an adventure.  We learned today that there are actually 2 stop-lights in town (mind you, this is a town of roughly 400,000 people).  YOu can see then hanging from a pole high above the street and covered up with a tarp. The stop-lights were actually put into use for the first time a couple of months ago but they only kept them operating for about 3 hours.  They had to shut them down due to the number of accidents they were causing!  You see, when you come to an intersection in Eldoret, there may or may not be a Stop sign but it really doesn’t matter.  You only slow down and/or stop if there is another car that is headed directly at you.  If there is any chance that you can get out in front of it before it gets to you, you go for it.  Fortunately, there is so much traffic that no one is moving very fast so at least high-speed accidents and injuries are relatively few and far between. 

While in town, we also had to stop at a bank to get to the ATM machine which worked just fine for most of us but unfortunately for Bill, the machine ate his debit card…he will be headed back to the bank first thing when they open in the morning to see if they can retrieve it for him….if it were me, I think I might just call and cancel the card now…

And now this last little tidbit is for my parents, especially my dad…they may be the only ones to find the humor in it so the rest of you can feel free to skip this if you like….Dad, I have to tell you, when we were getting ready to leave the Imani workshop  and walking out to the van, I looked down the street to the left and saw a herd of cattle coming at me….it wasn’t moving very fast and some of them definitely had a hint of the Brahman hump and horns on them but they didn’t look too daunting….and there I was in the middle of the street….just like when we used to move cows down the road at home….all I had to do was stand there and they turned right into the grassy yard where they were suppose to go….could hardly keep from laughing out loud at the thought of you telling me to stand there all those years ago and don’t worry if the bull looks mad, he knows where he’s suppose to go….!

With that, we’ll call it a day.  Tomorrow we head out to the Burnt Forest Clinic…looking forward to another wild ride!

p.s. I’ve had trouble with the internet connection the last couple of days so bear with me as I try to get the pictures uploaded…they’ll get there eventually