Wrapping up at AMPATH

It’s hard to believe but we are wrapping up our fifth and final day here in Eldoret at the AMPATH facilities.  We started our day by driving about an hour out of Eldoret to an area called Burnt Forest.  I think its actually a town but we were on the outskirts visiting one of the satellite health clinics.  This clinic has a facility in conjunction with a local hospital.  The hospital is what they refer to as a “sub-district” hospital.   It operates 24/7 and has enough beds in its one ward to accommodate 20 patients.  The area it serves, what they refer to as the “catchment area”, has about 110 thousand people.  Most of the patients that visit this clinic are first time patients who are being tested for HIV or returning HIV positive patients who are coming in for a checkup. The clinic operates once a week, every Thursday and they see about 3500-5000 patients each year. 

The clinic is run quite smoothly and we were walked through the areas that a typical patient would experience in a clinic visit.  They start out in a registration room and then go to a triage room where a nurse takes their vital signs.  If they are in need of immediate care, they would move on to another room where a nurse would further triage them and determine if they need to see a Clinical Officer.  Clinical Officers are similar in qualifications to Physicians Assistants or Nurse Practitioners in the US.  If they don’t need immediate care, they wait their turn to see the Clinical Officer for an exam and consultation, they may see a mental health nurse, get blood drawn, and go to the Pharmacy as needed.  The hospital facility also has X-ray capabilities and a lab where they do rudimentary blood tests.  They can administer IV fluids but do not have blood transfusion or surgery capabilities.  If this type of treatment is needed the patient will need to go to Eldoret, which most of them can’t afford to do. 

The main vocation in the Burnt Forest area is agriculture and we were told that the attendance at the clinic today was light because the farmers were out in their fields.  It’s just about time for the rainy season to start and the farmers need to have their fields tilled in hopes that next week the rains will begin and then they will start their planting.  This particular area is said to be quite fertile and it’s at an even higher elevation than Eldoret (which is about 7000 feet above sea level).  It’s very dry and dusty now but I did notice that the soil had a higher dirt to clay ratio….it wasn’t as deep red as what we have seen and walked through in Eldoret,  more of a brown color.  I tried to get a good look at the landscape as we drove to the clinic and I noticed some corn fields and lots of pasture land.  Some of the corn fields have been tilled and the pastures looked pretty parched.  Lots of the cows and sheep were grazing along the road-side ditches for the last vestiges of any green vegetation.  Evidently once the rain starts everything becomes very green and lush and is a beautiful sight….and maybe the animals will be back in the pastures then.

I had difficulty getting a good look at the landscape during the ride because we had piled 8 adults into a 7-seater SUV.  I and Darren had the luxury of sitting in the two rumble seats in the way back of the car…we at least got to (had to?) stretch our legs out…we also had to hang on to the tailgate but at least we were on the inside hanging on!

We returned to Eldoret for a late lunch and spent the entire afternoon and evening in wrap-up sessions.  It was good to download our thoughts and ideas for potential next steps with our hosts and also start to prepare some presentations and proposals to share once we get back to Indy.

Tomorrow we depart from our hotel at 6 am and embark on the next stage of our adventure, our trip to the Masai Mara.  Here is a link to the camp where we will be staying. 

 http://camp-oloshaiki-kenya.com/

I was encouraged to see that each “tent” has its own bathroom complete with running water and flush toilets.  If you take a look at the accommodations on the web site you’ll also see that the bathroom actually is constructed as a fully contained stone-walled room….I will be sharing a tent with Mary Jo and have already warned her that if the monkeys or crocodiles or any other creatures decide it would be fun to join us in the night, she will be welcome to join me hiding in that stone-walled bathroom!

The trip to the Mara will be a long one, it will take about 6 ½ hours to get there by car.  The first 2 hours are suppose to be on fairly decent paved roads much like we drove on today to Burnt Forest (it took us 50 minutes to go 40 Km, which works out to about 30 mph just to give you an idea of what “good roads” are like).  However, the last 4 ½ hours will be on dirt roads….after riding in the back of the SUV today and anticipating the jostling and jarring to come, I may need to have Larry call and make me an appointment for a massage or a chiropractor visit when I get home!

We are all definitely looking forward to a little down time as we’ve been going full out since Sunday morning and a bit of a break will be great….the fact that we get to take our break in one of the “Seven Wonders of the World” hasn’t really sunk in yet.  We’ve really enjoyed our time with our hosts here and believe that we’ve made good progress toward assessing possible opportunities for Lilly to further support some very important AMPATH initiatives.  Many thanks to Yi-An and his colleagues for making us feel welcome and opening up their facilities, their homes, and their minds with us these past 5 days.

I can’t imagine that I’ll have internet access while on the road or in Masai Mara so I expect this will be my last blog for a few days.  I’ll take plenty of pictures and will look for an opportunity to check back in once I’m back in Nairobi on Sunday night so don’t worry if you don’t hear from me for awhile…I’m sure those stories about the monkeys stealing cameras and throwing “stuff” down on the roof of the tent at night aren’t really true anyway….