I arrived in Nairobi April 2, and spent the next 3 days with Liz’s sister Kathy and brother-in-law Dan, mostly recovering from jet lag. I also spent a morning with Dan in Kibera (said to be the largest urban slum in Africa), touring a clinic and a girl’s primary school; paid a visit to my colleagues at the Kenya Hospice Association, and had dinner with the Buckwalters, who are leaving Kenya after four years on the family medicine faculty.
On April 6, Dan and I set out on the 8-hour journey to Western Province; although the road is much improved from 20 years ago, the truck traffic makes for a very slow trip.
We spent the first day with Ray and Jan, the couple who replaced us in Lugulu, but who have since joined the family medicine faculty at Webuye District Hospital. They have lived in East Africa for most of the last 25 years, so have an interesting perspective.
Then on to Friends Lugulu Hospital, where our family lived and worked from 1991-94, and where I have returned for 1-2 month working stints on 3 occasions since. Our old house is now the guesthouse, so I slept in the same bed as when we lived there. Grace, our housekeeper back then, now is in charge of the guest house, so it really was all very familiar, including the usual lack of running water and intermittent power outages.
The hospital is struggling. I guess I always say that, but this time it does seem that morale is the lowest I have seen it, and the finances seem precarious. I had hoped to spend my five days there just visiting, but of course there is always something to do, so I did spend some mornings making rounds and seeing patients. Mostly, though, I just listened to people’s frustrations and fears. At the end of the five days, after lengthy sessions with the head doctor, the administrator, a board member, several nurses and clinical officers, and a couple of sacked employees, I felt that I was doing some kind of “institutional therapy.” Culturally, people here are not always very direct with one another, so perhaps the presence of an outsider (though known to and hopefully trusted by many) gave them an opportunity to try to work through some of their conflicts. I do leave Lugulu with a sense of great concern about the hospital’s future, and with the extra burden of feeling this may be my last opportunity to visit.
I was able to participate in a couple of teaching sessions with the family medicine registrars at the District Hospital (basically, a family medicine training program for Kenyans, parallel to my job at LGH), so that was interesting.
I have today moved on today to Kaimosi Hospital, where I will be helping to lead a small pre-conference workshop on tropical medicine. Then we all travel to the World Conference on Tuesday the 17th.
Liz arrived safely in Nairobi on Tuesday, and is busy there with conference preparations.
