Tuesday, October 5, 2010

Vipi from the City Under the Sun

Hello US,

A quick hello from Nairobi! I am actually on my way home for a number of different reasons. First, I am fairly ill and think it would be best to have someone other than myself treat me and second, there was some drama at my site and the ministry of health got involved. I figured as a sickly, non-citizen, volunteer, it was best for me to get out. None the less, it has been a marvelous experience and I do plan to write a book about it. I should be state-bound by the 7th or 8th depending upon when I can get a flight out of here. Last night I guiltily treated myself to a nicer hotel in Nairobi....I nearly cried aloud when I saw carpeting, a hot shower, and a big 'ole bed with puffy pillows. I wish I had the energy to explore a little more but think I need to take it easy until I gain some strength. I can't wait to see everyone when I get home, I miss you all more than you could ever imagine! Thank you for keeping me sane these past two months!

Lots of Love,

Kyle

Saturday, September 18, 2010

Habari Yako!

Habari Yako!

I apologize it has been a while via telephone...internet...anything! My cell phone died on Tuesday and the Western Province did not have any power for the better part of the week. I breezed through some of my other blogs and was upset that they all sounded so doom and gloom. I do have my moments (actually a lot of them), but overall I know I am gaining experience, knowledge, perspective, etc. It still kills me that I can't contribute more (whether it be monetary or not), but I am doing the best I can. My KiSwahili vocabulary has improved three-fold but I am still on the JV team. I have still been keeping a journal diligently, so I can either write something when I return, or give you more later.

Let's see.....

This week I had to stitch a girls face who split her lip open after a spill. I have never stitched before and did a pretty poor job on mom's porch cushions, so I was a little apprehensive. The poor little eight year old is probably still numb from all the Lidocaine I injected her with, and I am afraid I may have caused a cosmetic catastrophe. I had to straddle the poor soul as her daddy held her arms and head. She comes back on Monday to get them removed....we will see how I did? YIKES!

Two weeks ago, I went home with Irene to her family's house about a 1/2 hour boda boda ride away. Her mom gave me a live chicken as a customary gift (I do have a picture documenting my face of appreciation/terror). I didn't know whether to name it, put a collar on it, or what? We recently had chicken for dinner and I haven't seen Henry lately : (

That boy is alive and well (thank goodness) I saw his schoolmate on the street and asked how he was feeling and he said, "All better!"

Poor little Alexi has malaria again. I cycled to the chemist who surprisingly is open on the weekend to get him some quinine and their version of tylenol. No sooner did I get it in him, he yacked all over the floor. You don't want to know how vomit is cleaned in the Bush....let's just say I had a flashback to elementary school when I saw the janitor dumping powder on a pile of barf. They don't like it when I pick him up and cuddle him (even though he is 5) because they say he is not a baby. It kills me not to be able to give him some tlc, because he is so sick.

I can't remember if I have mentioned my colleague Johnson or not. He's a magnificient person with a heart of gold. Not only does he support me through all my minor mental breakdowns, but he is financially supporting his family of ten (mom, dad, brothers, sisters, etc.) with food, school bills, etc. When I hear him talk about his struggles, I am so humbled because ALL of my problems that I have and have ever had pale in comparison. I am not sure how he stays so positive and level headed all the time.

He is pretty much my sole friend here, aside from Irene and Isaac because I am still not allowed to leave the house without someone. Coming to this little internet cafe in Nambale with Irene shopping nearby is pretty much the only alone time I get. I have not been able to access my emails and apologize that I can't respond to everyone ( Thank you Jo Jo and Sinead, I miss you dearly!). I sometimes can get on facebook (M+ D you should probably get one), and skype is way out of this areas league.

I should probably wrap things up because I think Irene is coming soon but I can't even express to you how much I miss everyone. I have noticed myself changing in more ways then I thought, but I am still the same Kyle. It's difficult to stifle some of my sense of humor sometimes...I am not sure how it would be received. The program director of WorldCorps is looking to place me in a hospital or a more English speaking area. In the meantime, I will be able to hang in there and hopefully not cause any poor child harm. Prescribing and treatment has become a lot more routine because it's a lot of the same diseases with the same drugs (just different weights).

Kenyans love American music and since the radio is always on in my house, it is my link back to Uncle Sam. They play the same 12 songs over and over again, a curious mix of Celine Dion, 98 degrees, Toto, Shania Twain, and some other one hit wonders from the 60's and 70's. Every time I hear the song "Red, Red, Wine" I think of how wonderful it would be to have an ice cold brew. Miss you all oodles and hope to chat soon!

Cheers,

Kyle

Saturday, September 11, 2010

I MISS YOU from Nambale!

Dear All,

Thank you so much for your kind words and posts, it's just what I needed right now! I went to Busia town today (2+ hours of commuting) and the internet cafe did not have network. For the last week + my cellphone hasn't had network either because the rainy season has started. The rainy season, in the Western Province, literally means that it rains everyday like clockwork at 4pm. It's been pretty difficult to keep my spirits up of late. I have learned to speak some more Kiswahili, but what I have come to learn is that the villagers don't even speak that. There are 42 different tribes in Kenya, which means 42 different mother tongues (completely different languages basically). So I am pretty much at a loss, language-wise. As a practitioner (and one of the biggest reasons I wanted to do this trip in the first place) it absolutely essential to be able to communicate and understand your patients. I am unable to perform patient teaching due to the language barrier, which absolutely kills me! Work goes by relatively quickly because there is never a shortage of patients ( I see an average of 35-40/day). I am in charge of the consulation room which is where patients triage in, I ask them what's wrong (going through my list of symptoms in Kiswahili), I do a brief examination and either send them to the lab for testing, refer them, or write prescriptions right on scene. In the US, RNs do not have prescription rights, which explains why I was really nervous to start doing that in the first place. I have pretty much gotten the hang of malaria, typhoid, dysentary, septic wounds, but everytime a new rash or fungal infection comes in, I am always perplexed. There is no such thing as worrying about overprescribing antibiotics...painkillers, etc. I write for Amoxycillin like candy and all the while am worried that I am creating a village worth of children that will have penecillin resistance. Some patients have really touched me, and other have brought me to tears of sadness and anger. It must be circumcision season right now, because I have had more than a dozen patients coming in with septic wounds of the genitals. I am assuming that they are all coming from the same place and that the place they are coming from are not using sterile instruments. It breaks my heart to think that these little 15 y/o boys could be contracting HIV (among other things) all because I place is not sterilizing their instruments. I notified management, but that is all my language skills will permit me to do. Almost half of my patients come in, and I write for prescriptions that the dispensary doesn't carry. Most of the people don't have money to pay for the drugs themselves and I am pretty sure they just do without. I hate letting them leave untreated especially when I know it is bad. One girl, I actually took via motorbike by myself to the hospital to get IV antibiotics and a solid sterile dressing. She had been walking around for over a month with a septic wound to the bone. She was retarded and had sickle cell, and her mother had pretty much abandoned her. She was also 18y/o , 1 year older than the average person with sickle cell in this area lives. When I mentioned to the staff my plan for her, they kind of looked at me like, why bother? There was no way I was going to let this poor girl suffer in pain while her leg turned gangrenous and body got septic shock. This is just 1 of 897358312758 patients that could benefit from getting further treatment, but I lack the money, the resources, and the language skills to really be able to do so.

The afterwork hours I dread...they are lonely, quiet, dark and limiting. While I and I do speak English when I speak to them, they (and the rest of the extended family) speak in their mother-tongue of which I can understand nothing. It gets dark almost an hour after I get home from work, and I have a few flashlights and book lights that I brought to keep the whole house very dimly lit. Kenyans have excellent vision and night vision, two things I do not! I and I will not let me out of the house past dark, because "it is not safe and I had to argue once when I was running to the latrine that I REALLY REALLY needed out! I have adapted to the home life and survival skills as much as I can, but absolutely EVERYTHING is foreign. I finally made a friend at work (his name is JO! hahaha, I must like Jo's!)

I have to run because time is limited and it is going to rain soon. I wish I had time to write more, or better yet, see you all in person. I am not so sure if this trip is going to be 4 months anymore, but I will be sure to keep you all posted. I have been diligently writing in my journal everyday and will give you all more updates later.







Miss everyone so much and will talk to you asap!

Hugs and Kisses,

Kyle

Saturday, August 28, 2010

Hello From Busia Town!

Dear Family and Friends,

Greetings from Kenya! I apologize for the delay in my first post abroad, I don't think I had any idea how far into the bush I was going to be. I am sitting in an internet cafe in Busia, Kenya, which took about an hour to get to from my hut, by various means of transportation. The closest town to me is Nambale, but the actual village I am staying in is called Bumutiru. It has been quite the experience so far, and I have not slept very much. I have been running on adrenaline from pure culture shock!

Where to begin...I am living with a young couple, Isaac and Ireen in a 14X20 foot straw and cement hut with no running water, and a small lantern to keep things light after 7:30pm. They are really nice and accomodating, but it is hard to keep myself occupied with all of the down time. The biggest set back of all is that NONE of the locals speak English! I really wish I would have been told that before hand because I totally would have learned a few key phrases in Kiswahili. I am learning small vocabulary words slowely (mostly medical ones that help me at the clinic) but much of my day is spent in silence (unless I am talking to Ireen and Isaac). I will never complain about a dirty American bathroom ever again...the latrines are awful!

The clinic I am working at is not a hospital, though it does have a few beds for overnight stay. There is one nurse, one doctor, usually a student, and one lab tech. I was pretty much thrown right into things from day 1 and serve as the nurse, the doctor, the pharmacist, etc. I write prescriptions and often times give injections of the prescriptions I have just written. I live in constant fear that I have either written for the wrong drug, or misdiagnosed a patient. My training does not qualify for what I am doing, and the only crutch I have is a 1991 copy of the British formulary which I hold onto for dear life! I brought some medical supplies and a stethescope and BP cuff with me, which have magically disappeared. The hygiene practices at the clinic are what bother me most. They do not have running water so the only way you can wash your hands in by dumping a jug over your hands. Thank goodness I brought so much Purell!

The children are my favorite! They all wave to me everytime I pass by on my boda boda (motor bike) to work. White person is "Munzungoo" in Swahili which is one word I learned quickly. I can usually tell when people are talking about me, but I usually have no idea what they are saying. I get laughed at often because I have no idea how to do some of the daily living stuff. I have pretty much be appointed designated Molly Pitcher, because fetching water is one thing I have mastered. Drinking water is about a 1 1/2 walk both ways (and yes I learned how to carry it on my head!)

Kenyan culture couldn't be further from American culture, though I am slowly becoming accustomed to it. The women definitely take a back seat to the men, although you can see the nation is slowly moving towards becoming more Westernized. The government just passed a new constitution yesterday which hopefully will make some huge changes in the economy and political stability. Kenyans are absolutely obsessed with Obama and the fact that he is part Kenyan. Radios are constantly on everywhere, and I have heard more renditions and remixes of Toto's "Africa" then I ever thought were possible. The food is interesting... I can't say that it's awful, but I think it also helps that you can't really see your food in the dark or dimly lit rooms. I have eaten lots of bananas and lots of Ugali (a staple in their diet- it's like grainey play-dough with a less salty taste).

The Kenyan countryside is absolutely beautiful, although it is hard to appreciate it with all the poverty around. Most Kenyans live on less than a $1 a day which is why something like coming to an internet cafe is really hard to do. I am not sure when I will be able to come back next, so I am going to give my parents the info to update this blog via cell phone. I do have a cell phone and usually get service, although international charges are expensive. My number is 0701397405. I am going to try and call people, depsite the 7 hour time difference. I am keeping a diligent written journal of my adventures and experiences including my first house call to fix a botched and hemorrhaging male circumcision on a 15 year old boy. I felt terrible for the kid, who was fighting back tears the whole time... I knew he was in extraordinary pain. I did not have a suture kit with me, so I tied one of my t-shirts around it and sent him on a boda boda to the nearest hospital and prayed for the best. As soon as he left, I ran straight to the latrine and vomited. HIV is everywhere, but even worse is malaria. I diagnose and treat about 35-30 kids a day with malaria. Typhoid is also another biggie in this area.

I will update as much as I can, but I am certain it won't be as much as I a had once hoped. I miss everyone dearly and am already looking forward to returning in December.

Sending lots of love,

Kyle

Thursday, August 12, 2010

Last Night in Ringoes

I am not at all surprised that I am still up at this hour...my head is spinning with excitement, anxiety, uncertainly and adventure, with a side of insomnia (from my new found favorite malaria drug, Malarone!) Side effects are said to include wild dreaming and it's no joke! Last night Nick and I went sailing on his new dingy sailboat only to be swallowed up by a mechanical shark with sharp metal teeth (and I swear I don't watch River Monsters!) I am so looking forward to falling asleep tonight because the dreams are sure to be wicked . . . and I am really surprised this drug doesn't have street value.

The last few days have been nothing short of crazy: errands, preparing, packing, and car accident included. I am pretty notorious for hitting stationary objects in parking lots, so yesterday was just a little reminder that I am still a bad driver with poor depth perception. Deciding to take Mom's car was my first mistake, pressing the accelerator instead of the brake before hitting the "PNC Customers Only" sign was my second. Of course it was in front of a huge window of investment bankers all looking at me like I am a crazy woman driver. They're correct.

So I go into the bank where I am greeted by investment banker # 1 who politely inquires "so you havin problems out there?" I apologize and then decide it's appropriate to tell him that I am moving to rural Africa where there aren't any cars. He laughs, then goes out to check out Mom's Lexus and his PNC property which is now at a 45 degree angle to the mulch and bush it once stood proudly in front of. I told the man I would be happy to pay for the damage (even though there really was nothing except for a bent sign.) He however, had different plans and told me to go home a get a shovel, dig out the knocked over sign and replant it in the mulch. I immediately call Nick and politely ask him to "come to PNC bank with a shovel, don't ask any questions, and don't tell Mom."

Nick comes and saves the day, digging the sign out and bending it back so it's now only slightly leaning. Thank goodness for loyal brothers! (Nick, I owe you a case of beer.) How about just a little humiliation before departing the country?

Less then 36 hours until I touch down in London-town! My goal is to eat as many Crunchy and Flake bars as my stomach will allow in the Heathrow Airport, before starting my third world weight loss plan. I am really really really going to miss everyone, but look forward to communicating via email krbahn@gmail.com and blog.

Lots of Love,
Kyle

Saturday, July 31, 2010

One Step Closer!

I got my passport today (thank you priority mail)! This was of course after another exhilarating trip to the US Customs House in Philly. I brought my old man for round two, in case things got ugly. The morning involved a lot of uneventful waiting until this this 87 year old Vietnamese woman started shouting at the armed guards for trying to escort her out of the building. Apparently, she didn't have the right documentation, but seriously: give the little old lady a passport for crying out loud! She's already got enough working against her, and she's probably just trying to get back to the motherland. Unfortunately, these guards took their job of protecting the portrait of Hillary Clinton a little to seriously, and proceeded to manually escort her off the premises. Already making a scene as her walker rolled over the toes of everyone seated in row 7, cute little Vietnamese lady promptly face planted right in the archway of the entrance/exit. Strategic landing. Laying prone on the floor, this poor old woman (who according to my father, "couldn't have weighed more than 47 pounds,dripping wet") started screaming in Vietnamese while her extremities flailed on the floor. The guards who all clearly paid attention during the "what to do in case of an emergency" training module left her lying on the floor, face down while they called an ambulance. Assuming that five full grown men could handle a woman of her stature, I continued to sit in my seat and wait for gosh-darn number six to be called. Less than five minutes later, I decided it was time for Kyle Bahnsen RN, BSN to intervene and make sure there was still a patent airway and adequate bilateral circulation to her pelvis. After a cursory head-to-toe assessment, I gave the very professional, very elaborate medical advice to... put her in a chair. Thank you Department of State for such a wonderful experience and congratulations Chelsea on your upcoming nuptials!

P.S. I spoke to to my host-father, Isaac! I didn't understand a word he said but he has such a kind voice!

Tuesday, July 27, 2010

What doesn't kill you, only makes you stronger.

God willing, I am scheduled to depart for Busia, Kenya August 13, 2010. This is of course if I can get my hands on a visa and passport, and or don't spontaneously combust in the process. For all of you travelers out there, DO NOT, I repeat, DO NOT send your passport away for a a visa in the mail because FED EX is undeniably incompetent and will lose it en route to your home just weeks before your departure. "What can brown do for you?" A whole hell of a lot more than Fed Ex, that's for certain!

And this is how my trip to no-mans-land, Africa begins. . . an omen, perhaps? Will it stop me? Absolutely not!

After the Fed Ex fiasco, I decided it was no longer a good idea to trust sending legal documents through the mail. What I didn't know was that hand-delivering things wouldn't be any easier. 5 and a half hours of waiting in line and an additional $200, I thought I finally had my new expedited passport from the US Customs House in Philadelphia. Nope. Their passport making machine was down, and they were going to have to mail it to me by the end of the week. Okay, whatever. Fast forward 12 hours when I get a call from Lois saying the passport photos AAA had taken had a huge line through the center of my face, not visible to the naked eye, and they could not be used for my passport. Really!?!?! So back to AAA for new photos and let's throw in the post office too in case yet another "line" is found on my face!!! Tomorrow it's back to Philly to wait in line again for 5 hours to drop off two sets of pictures with no lines and definitely no smiles! Monday, it's back to get another lethal injection of rabies vaccine and off to NYC to find the Kenyan consulate for a visa. Rat race part II begins!