Healthcare in rural Kenya has seen slow, but sure growth in recent years. Access to resources, insufficient funding and lack of professional staff are still major obstacles that current healthcare providers face. Students from Western Kentucky University traveled in January of 2019 to Kasigau, Kenya to participate in the healthcare system and experience first hand how healthcare differs in a developing country.
Kasigau, Kenya
15 passenger vans called matatus are another form of public transit in Kenya besides motorcycle taxis. A matatu brings WKU pre-med students into Rukanga to help in patient assessment.
Breastfeeding gives infants crucial antibodies that protect against malaria. Children six months to five years old are at the highest risk of getting malaria. Women in rural Kenya may not have access to sufficient pre- and post natal education and care. Simple practices like breastfeeding can reduce infant mortality which is one of Kenya’s millennium development goals.
Rheumatoid arthritis and diabetic neuropathy are two common conditions that prevent patients from traveling to health clinics in their respective villages. The roads that link villages to health clinics are not well maintained and the primary mode of transportation for rural Kenyans are motorcycle taxis, or boda bodas.
Western Kentucky University pre-med students work with a translator to do patient assessment. Medical terminology is often lost in translation. The term “shots” versus “injections” is a large point of confusion when providing treatment. The patient’s condition might be easy to diagnose, but translating the appropriate treatment plan remains an obstacle.
Patients wait outside the pharmacy of the Rukanga Health Clinic for their prescriptions. Simple over-the-counter drugs and low dosage antibiotics are more effective in rural Kenyan villages. The microbiomes in the rural areas are not resistant to antibiotics. Extensive use of prescription and over-the-counter drugs in the United States has caused bacteria and our body’s natural systems to develop resistance to many common drugs like ibuprofen and amoxicillin.
Timbo, the chairman of the Buguta Clinic measures the fundal height of a patient complaining of abdominal pain and consistent bleeding. Timbo gives a pregnancy test and confirms the patient is pregnant. Ideally, a cervical speculum exam would be given to determine if there was a miscarriage. The clinic does not have the sterilizing equipment necessary to perform the exam. The clinics main problem is that the practitioners are in a position to help patients, but lack the equipment.
At 9 months pregnant and due any day, the patient’s chief complaints are diarrhea and white discharge. Considering the complaints, prevalence of sexually transmitted diseases and her fast approaching due date, pelvic inflammatory disease is suspected. Untreated STI’s can lead to pelvic inflammatory disease and PID can also effect the patient’s digestion. A combination of antibiotics for the PID and gastrointestinal issues need to be carefully selected as to not jeopardize the health of the fetus.
Timbo examines an x-ray that was done in May of 2018. It may now be obsolete but it is one of few pieces of medical history the patient has. Health indicators in the x-ray are not visible which means fluid in the abdomen is present. Poor breathing sounds and a distended abdomen are the visible and audible symptoms of the excess fluid.
A paracentesis is a procedure to drain fluid. It will take a few hours to complete. About 9 liters of fluid were drained from the patient's abdomen. She has given birth to 14 children, seven of which have died. The youngest is 14 years old. Having a lot of children is equated to wealth so many women continue to conceive as they age despite poor health.
After school, children from Rukanga Primary School come to the clinic to socialize. The bench outside of the pharmacy is a shaded place to take a nap.
An albino boy came to the Rukanga clinic after falling and cutting his head at school. Albinism is a rare condition and often a heavily stigmatized condition in Sub-Saharan Africa. A physician’s assistant, Brian, described albinism as less stigmatized in Kenya, but in rural Tanzania, albinos are killed.
Dr. Mike Collins performs a paracentesis (draining of fluid) on a patient suffering from ascites (excess fluid in the abdomen or testicles.) Ascites can be caused by tuberculosis, liver disease— two common diseases among rural Kenyans. The medication to treat liver disease is available at Voi Hospital 63 kilometers away from the Rukanga Health Clinic. A taxi from Rukanga to Voi is too expensive for most villagers, but only $20-$50 USD. Dr. Collins paid for multiple taxis throughout the 18 days spent practicing in Rukanga. The conditions were too easy to fix to let a small taxi fee prevent treatment.
This was my favorite drawing of the day. James Muchina was our driver for the trip. We blistered up and down the red dirt roads for 18 days so many of us developed an attachment to James and our van. To the kids, James and his van meant the Americans were coming to the village. This is an artists rendition of our van. “America Car,” crayon on paper (2019.)