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