After 2 days in Nairobi, I'm starting to feel pretty settled in here. With a constant infusion of caffeine on my flight from Amsterdam to Nairobi, I managed to stay awake till 11pm Kenyan time (1pm PST) on my first night here and completely flip my circadian rhythms. I'm staying at a comfortable apartment with some truly excellent 70's decor -- there's shiny wood paneling and a velvet headboard on the bed!
Every morning, my trusty driver George comes to pick me up and take me to orientation activities. Yesterday, I met my project partner Noela Makotsi for the first time. She's very down to earth and funny. I think we're going to get along really well. She has just finished her first year of pediatric residency at the University of Nairobi, but since the Kenyan medical system is quite different from the U.S., she worked for 6 years as a general physician after completing medical school before she could even start the residency program. The more I learn about medical education in Kenya, the more grateful I am for the system we have in the U.S.
Noela and I did the orientation together and are now the proud (temporary) owners of 2 laptops and a satellite phone. Several of the meetings that had been set up for us didn't actually take place because the people we were supposed to meet were in other meetings or, in one case, not even in the country. But in my experience, that's just the way things go sometimes in global health settings.
One site I was disappointed to miss was Kenyatta National Hospital (KNH), which is the largest public hospital in Kenya and the site of the pediatric residency program. Unfortunately, the pediatric residents and all the other sub-specialty residents are on strike as of yesterday to protest their working conditions and lack of adequate compensation (or really any compensation) for the hours they work. No one is sure how long the strike will last but it has already ground the hospital to a standstill. I'm hoping that we can visit KNH when we get back from Kisii.
We did get to visit Gertrude Children's Hospital, which is the only private children's hospital in Nairobi. John Kamenwa, one of the pediatric residents who did a project in Kisii last year, took us on a tour of Gertrude's. It's a well-funded facility with specialty clinics, a surgical unit, multiple inpatient wards, a child development center and even a 4-bed intensive care unit with ventilators. The patients all have private rooms where a parent can stay with them and the nurse-to-patient ratio seems similar to what we have in the U.S. This is a hospital where ex-pats and wealthy Kenyans bring their children, and you have to pay cash or have private insurance to be treated there. The down payment for admission to the ICU is 500,000 Kenyan shillings which is about $6000.
Both John & Noela drew several comparisons between Gertrude's and KNH during our tour. The pediatric ward at KNH has an average of 100-150 patients with only 2 nurses to care for all of them. The babies are often housed 4 to a single bed and children are 2-3 to a bed. Their mothers sleep on the floor under the beds or have to find their own accommodations. In the pediatric ICU at KNH there only 2 ventilators and 1 CPAP machine. But as a public government-funded hospital, KNH has to treat all patients regardless of their ability to pay. Although, patient's families are still required to pay for some medications and other treatments and they may not let you take your child home until you settle your bill!
All of this has given me a lot to think about. Having this wide a gap in quality of care between the wealthy and the poor in Nairobi is unsettling enough. But I think when we go to Kisii, we will be confronted with even wider disparities and even fewer resources to try to bridge the gap.
But to end on a lighter note and go back to the title of my post....I have yet to eat any Kenyan food in Kenya. On my first day, I had a BLT+avocado sandwich for lunch at Java House (Kenya's answer to Starbucks) and then, I wandered into the Happy Love restaurant which is next door to my apartment and discovered that it was run by a Korean family! So I had some delicious bibimbap for dinner. I've also been drinking plenty of Kenyan tea, which is quite light on the tea and heavy on the milk & sugar.
Tomorrow, Noela and I will leave for Kisii to begin work on our project. Our trip is going to take us through the Rift Valley so I'll try to take some pictures and post them here. Until next time, kwaherini!
Ammu
Every morning, my trusty driver George comes to pick me up and take me to orientation activities. Yesterday, I met my project partner Noela Makotsi for the first time. She's very down to earth and funny. I think we're going to get along really well. She has just finished her first year of pediatric residency at the University of Nairobi, but since the Kenyan medical system is quite different from the U.S., she worked for 6 years as a general physician after completing medical school before she could even start the residency program. The more I learn about medical education in Kenya, the more grateful I am for the system we have in the U.S.
Noela and I did the orientation together and are now the proud (temporary) owners of 2 laptops and a satellite phone. Several of the meetings that had been set up for us didn't actually take place because the people we were supposed to meet were in other meetings or, in one case, not even in the country. But in my experience, that's just the way things go sometimes in global health settings.
One site I was disappointed to miss was Kenyatta National Hospital (KNH), which is the largest public hospital in Kenya and the site of the pediatric residency program. Unfortunately, the pediatric residents and all the other sub-specialty residents are on strike as of yesterday to protest their working conditions and lack of adequate compensation (or really any compensation) for the hours they work. No one is sure how long the strike will last but it has already ground the hospital to a standstill. I'm hoping that we can visit KNH when we get back from Kisii.
We did get to visit Gertrude Children's Hospital, which is the only private children's hospital in Nairobi. John Kamenwa, one of the pediatric residents who did a project in Kisii last year, took us on a tour of Gertrude's. It's a well-funded facility with specialty clinics, a surgical unit, multiple inpatient wards, a child development center and even a 4-bed intensive care unit with ventilators. The patients all have private rooms where a parent can stay with them and the nurse-to-patient ratio seems similar to what we have in the U.S. This is a hospital where ex-pats and wealthy Kenyans bring their children, and you have to pay cash or have private insurance to be treated there. The down payment for admission to the ICU is 500,000 Kenyan shillings which is about $6000.
Both John & Noela drew several comparisons between Gertrude's and KNH during our tour. The pediatric ward at KNH has an average of 100-150 patients with only 2 nurses to care for all of them. The babies are often housed 4 to a single bed and children are 2-3 to a bed. Their mothers sleep on the floor under the beds or have to find their own accommodations. In the pediatric ICU at KNH there only 2 ventilators and 1 CPAP machine. But as a public government-funded hospital, KNH has to treat all patients regardless of their ability to pay. Although, patient's families are still required to pay for some medications and other treatments and they may not let you take your child home until you settle your bill!
All of this has given me a lot to think about. Having this wide a gap in quality of care between the wealthy and the poor in Nairobi is unsettling enough. But I think when we go to Kisii, we will be confronted with even wider disparities and even fewer resources to try to bridge the gap.
But to end on a lighter note and go back to the title of my post....I have yet to eat any Kenyan food in Kenya. On my first day, I had a BLT+avocado sandwich for lunch at Java House (Kenya's answer to Starbucks) and then, I wandered into the Happy Love restaurant which is next door to my apartment and discovered that it was run by a Korean family! So I had some delicious bibimbap for dinner. I've also been drinking plenty of Kenyan tea, which is quite light on the tea and heavy on the milk & sugar.
Tomorrow, Noela and I will leave for Kisii to begin work on our project. Our trip is going to take us through the Rift Valley so I'll try to take some pictures and post them here. Until next time, kwaherini!
Ammu
