The top picture is of me teaching at the Ukwala Clinic and underneath is me again on the road to Kisumu
Onto the second site-the clinic and soon to opened hospital at Ukwala, a small town north of Kisumu near Lake Victoria. First into their Nairobi office to meet the country director, Daniel Okala, a diminutive man bursting with ideas and enthusiasm. It was impossible not to get caught up in them and imagine phenomenal health care rolling out from this center. A discussion about my possible role and then back to Kenyatta airport to catch the flight to Kisumu and from there the ride to Ukwala. Naturally no one was there to meet me but, whipping out my trusty mobile phone, I was able to contact dear Winnifred and about 30 minutes later, the driver did show up. Seems they were in Kisumu buying water for me. Heading north on a real tarmac road, dodging potholes that threatened to swallow the car, the driver, probably about 20, wanted to overtake anything in his path. After about 90 minutes, we swung off onto a dirt path and followed the same drill. Around dark we got to Ukwala and I was deposited in the Parish House where there were quarters for the volunteer staff. Met and had supper with the area priest, a delightful man with, sadly, severe rheumatoid arthritis. Meanwhile John who had traveled by bus was stuck somewhere and did not make it to Kisumu until midnight and stayed overnight there. Evidently the gendarmes were out in force checking on vehicles to be sure they had the proper inspection and insurance documents and were not overloaded. Since few of them had any of the necessary certificates and most were overloaded, there was a long line of vehicles taking devious circuitous ways around the roadblocks. He did finally get to Ukwala the next day at lunchtime.
Onto the clinic-a good facility and well run. Met the doctor who was frosty. I do believe that she was concerned for her position. I worked with the clinical officer in the morning and there were very interesting patients to care for-malaria, infant with HIV and kwashiorkor, young man with granuloma inguinale. On the walk back to the parish house where John was waiting, I noticed a government clinic across the road. It appeared well staffed. In the afternoon we walked out about 2 kilometers to see the new hospital that was being built. Lovely location in a large field with a good view of the surrounding hills. It was quite large, a cement structure, built in tukal style with a diameter of about 100 meters. It had 10 patients rooms with one bed each but could expand to two beds/room. Each room was being equipped with tv and Internet connection. Two nurses' stations with total visual contact. This is to be a pediatric unit and there are plans to expand to a 200 bed women and children's hospital. Wonderful design and idea but what I believe is a waste of resources for the reality of the area that it was in. You could build a more practical structure at less cost and use the monies to purchase diagnostic equipment and an adequate supply of medication. They have received money from their American sister foundation, Tiba, and the Clinton Foundation as well as Pepfar money. Still, from my experience, those sources tend to dry up and you are, all to often, left with nothing to continue. One year in Darfur we were functioning on $250,000 and the next, we were expected to expand services on $150,000.
Day#2 here in Okwala-back to the clinic and there were only a handful of patients so that we were done by 1100. Across the street the workers at the government clinic were on the veranda reading and chatting as they also had little to do. At lunch John and I decided to leave at it was clear that, at this point in time, they really had no need of us. This was Friday, the 26th of August. Luckily the priest was leaving after lunch to go to Kisumu. We called our contacts there, clambered in Father Fred's car and off to Kisumu to spend the night and move onto Kendu Bay on Saturday. But, like "The Perils of Pauline" that adventure will have to wait until later.
