Kenya update 2/10/2016

Habati from Western Kenya!

The LSU/SHIP team traveled south today to Musango church for our eighth mobile clinic day. The trip was about 1 1/2 hours down past the cane fields and the sugar mill.

The crowd was light today, but we continued to see kids with malaria, scabies, jiggers, and impetigo. We had some adults with interesting diagnoses: a gentleman with filariasis (elephantiasis), which I had seen only once before; another had a classic case of varicella zoster (shingles); and a 50 year old lady with a large thyroglossal duct cyst. This problem is an embryologic remnant that fails to close, and is usually picked up in childhood. Her cyst is so large because it has had a long time to accumulate the mucoid fluid that makes up the contents of the cyst. The problem can still be repaired, and we referred her to the hospital for care.

One lady came by selling sweet bananas, and another selling passion fruit, so lunch was quite tasty, and not limited to beef jerky and nuts, my usual fare.

Our pharmacy supply has not been very organized, making it difficult to know what drugs we have on hand,and what meds are getting low and need re-supply. Fran and Brittney were assigned to pharmacy today, and made short work of organizing our meds. On arrival back home, we found that Dr. Amy and Morgan Merriman had cleaned out and organized the pharmacy closet in the clinic building. Hopefully we can keep it that way.

Overall, the nice weather, the ideal location, and the light patient load made for a pleasant day.

Dinner tonight consisted of lentils, rice, kale, and chapati.

Tomorrow is the last clinic day for the students/residents doing the two week block, and for Dr. Amy Givler. We will be in Bulimbo, so come by to see us if you are in the area. If not, another update is planned for tomorrow evening.

Please keep us in your prayers. God has blessed us so far with good weather, only minor illnesses and inconveniences, and a great team to work with here in Kenya.

No photo with this post; my team members are hogging all the bandwidth!

Usiku mwema!

Kenya update 2/7/16

Hello from the LSU/SHIP team in Bungoma, Kenya!

I don’t have a lot to report after a weekend of rest–the long flights over, the jet lag, and immediately beginning work after our arrival in Kenya had taken their toll on me, so a weekend off was much needed.

Seven of the team went on safari to Masai Mara, and have returned excited and exhausted, with tales of the wildlife and other sights. There were some hard core bargainers in the group, and the stories of their souvenir shopping are amusing.

Brittney, Fran and Dianna took a day trip to Kakamega rainforest, and spent the rest of the weekend manufacturing a free weight gym with Maurice. I am quite impressed with their ingenuity. Then Dianna and Brittney learned to make chapati, and to cook over an open fire.

Another week of mobile clinics begins tomorrow with Lumboka. We are looking forward to serving God and the people of western Kenya, and as always, appreciate your prayers and support.

Mungu awabariki wote–God bless you all!

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Kenya update, 2/6/16

Greetings from the LSU/SHIP team in Kenya!

Saturday, a day to relax for the first time since last Friday. Seven of the students/residents are on safari at Masai Mara Game Preserve, and the other three are touring the Kakamega Rainforest Reserve. Don, Amy and I are enjoying the rest and cool breezes here at home. Don and Amy plan to visit friends in nearby Webuye later today.

I thought I would let everyone know a little about our routine here. Our schedule on work days begins early; some of the girls are up at 5 AM running and working out. We gather for breakfast at seven, and have a student presentation or other clinical discussion.

At eight, we trek across the drive to clinic headquarters to begin loading equipment and medications. Sometimes we have a local patient or two, and watch the children playing on the grounds of Epico St. Jahn’s Academy (Mama Betty’s school). Rena Brittenham, our case manager at LSU Children’s Center, sent soccer balls for the kids, and they are very excited to be able to play with a new ball.

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Kenya time can be a little imprecise, and travel time varies with the distance and conditions of the roads. We travel in what Bishop Reuben calls the “green fleet”, a Toyota LandCruiser, and a matatu, or van. When the whole team of volunteers and locals is loaded, it can be quite packed! We pick up some of our interpreters in Bungomatown, and generally arrive at the day’s site around 10 AM. After unloading and setting up, we are seeing patients by 1030.

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Lunch break may come between 1 and 2 PM, which is about the time the patient arrivals begin to pick up. Afternoons can be very busy, and frequently we have to cut off registration to be able to be done and loaded by 530. Then the trip home again, which seems longer for the tired students. All of the meds and equipment must be unloaded and stored in the pharmacy.

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We usually arrive home between 6 and 7 PM, where chai is waiting. A good cup of chai in the evening is great, and I may take up the habit at home. A hot shower and clean clothes feel wonderful; dinner is served about 730-800 PM.

I am not sure about the other team members, but I am in my bunk by 9-930, and I sleep like a rock!

Food

A missionary physician once told me that no one comes to Kenya for the food, but what I have experienced has been quite good. Breakfast is usually fresh fruit, and bread with an excellent jam and butter or peanut butter. Sometimes we have mangazi; think deep fried biscuit dough. Mama Betty makes them about the size of beignets, but they are sometimes bigger. Mangazi is fantastic with your morning coffee or chai.

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Lunch at the clinic site is whatever we bring with us. Snack bars, jerky and Slim Jims are popular, and some of the volunteers will make PB&J sandwiches. I will trade jerky with Mama Joyce for chapati, another fried bread; it looks something like a tortilla, but thicker, and quite tasty. A soft drink is provided; it usually isn’t cold, but no one complains. I have become quite fond of Stoney, a sort of ginger beer which I haven’t seen in any other country.

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Dinner is long on vegetables–stewed kale, mashed squash, and lentils are common. There is rice with a little stewed meat; a couple of times this week we have had fresh tilapia from Lake Victoria. Kenyans use very little salt or seasoning; some volunteers bring Tony’s or hot sauce from home, which the Kenyans also seem to enjoy.

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Accomodations

As I mentioned before, the Lubangas have put a lot of work into making the accommodations for the volunteers more comfortable. There are now new mattresses on the bunks, light and electrical outlets in the huts, and flush toilets and hot showers in the bath house.

There are four huts with thatched roofs. Each hut has bunks for four volunteers. The huts are cool enough at night, but I usually don’t need my blanket until about 3 AM.

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The thatched roof “gazebo” (our term for it) is a nice, cool place to rest and relax, an impromptu exercise room for some of the girls, and a sort of common room for card games and conversation.

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The main Lubanga home is the meeting place for meals, planning the day, and catching up on email. There is also a guest room for volunteers, where I am accommodated this trip.

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The much improved bath house has a new roof, two flush toilets, and three showers with hot water.

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We still obtain water from a had-pumped well, and use LifeStraw or SteriPen to make sure our American GI tracts will not be offended. Laundry is done in a five gallon bucket; I brought travel packets of liquid Tide, which seems to work well. Then rinse in another five gallon bucket, and hang your clean clothes on the line to dry.

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Patients

Many of our patients are middle aged or elderly, and present with the aches and pains of a life of labor. We treat a lot of DJD/OA, and chronic injuries which did not receive attention when they occurred. There is some hypertension and a few patients with diabetes; this is apparently a fairly new phenomenon. Dr. Don thinks this is due to an encroachment of Western diet and lifestyle. There are very few smokers in rural Kenya; the COPD that we see is in middle-aged women. Most cooking is done over an open fire, but in an enclosed space, and years of cooking results in chronic lung disease.

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Children frequently present with impetigo, tinea capitis (scalp ringworm), scabies and jiggers (sand flea larvae imbedded in the palms and soles). They also have upper respiratory infections, as in the US, but very of the little asthma, allergies and eczema that we see at home. Malaria is frequently worst in the young, and these children may present quite ill. There are some children with sickle cell disease. In the US, these children would receive specialized care that would allow them to live into adulthood. Without this care, these children’s lives may be quite short.

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We have seen several apparent malignancies in advanced status, HIV, and surgical problems that cannot be handled by a mobile clinic. We refer these patients to the nearest district hospital (Bungoma, Webuye, or Kakamanga). The nearest subspecialty care is frequently at mission hospitals, often in fairly distant Eldoret or Tenwek.

There is one situation that reminds me of home. In the US, many patients will present to their physician, the hospital ED, or an urgent care clinic with upper respiratory symptoms, and will expect a Z Pack and a shot of Celestone. They can be quite put out if they don’t receive it. The situation is similar here with malaria. Some patients expect to be treated for malaria, and are upset when they are told that they don’t need it.

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Overall, the LSU/SHIP team is having a great time, working hard, and learning a lot about tropical medicine and the Kenyan culture. We are always grateful for your prayers and support.

Kenya update 2/3/16

Long day, short post.

Greetings from LSU/SHIP team in western Kenya!

Clinic on day three was at the church in Ng’ola; we saw many more patients today (156 by one count), and they included some who were sicker than those we treated on the first two days. Several children were treated for acute malaria; some adults were seen with heart disease, and one young lady with tuberculosis had developed a pleural effusion with decompensation.

I have been very impressed with this team of students and residents–they are like sponges, soaking up everything new to them. And there isn’t a whiner in the bunch.

We travel to Muanda tomorrow for the next step in our adventure. Please pray for our team as we try to bring some needed healthcare to western Kenya, and to spread the love of Jesus to our fellow man.

Good night, everyone!

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Kenya update

Today was the first workday for the SHIP team from LSU–holding clinic in the Samoya church, just outside Bungoma. We started out slowly, as the students and residents met all the Kenyan members of our team, learned to set up clinic, figured out the mechanics of using an interpreter, and met the challenge of a limited pharmacy. We picked up the pace as the day went along, and saw 135 patients by 5 o’clock.

I found plenty of children with which to play, and had a great time. I did have one unusual (for me) experience. There was one 2 year old little girl who was terrified of me, on sight. When I walked up to the station where she was being seen, she got a horrified look on her face, and screamed bloody murder. Her mother said that the child had never seen mzungu before, and had never seen a bearded man. Talk about stranger anxiety! I had to stay away from that station, but the poor little girl would look around every couple of minutes to make sure I was not approaching again.

Over all it was a very busy but fun day. I am grateful for this opportunity to serve God and provide needed medical care for these wonderful people.

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On to Kenya

I packed my bags last night, pre-flight
Zero hour five pm…

After all the preparation and anticipation, LSUHSC/SHIP team members are leaving today for Bungoma, Kenya for our Global Health elective and medical mission. Traveling to Kenya with me will be Drs. Don and Amy Givler, of the EA Conway Family Medicine Department; Dr. Sajel Lala (Campout Barbie), pediatric resident; and medical students Franciscka Macieiski, Lurah Welch, Melissa Davis, Robert Zaunbrecher, Diana Badkoobeh, Brittney Mitchell, Michelle Finch, and Naiha Mussarat.

Please be in prayer for our safe travel and health, and for this extension of the healing ministry of Jesus Christ to Kenya.

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Thank You!

Thank you and God bless you to those who donated to make the Kenya mission trip possible, including Teri Poindexter, Colleen Sicard MD, Paul Cooper MD, Jennifer Kelley MD, Rose Brouillette MD, Marlene Broussard MD, Holly Gill MD, and the United Baptist Church WMU (Sybil Brown). I appreciate the gifts, and I especially appreciate your prayers as we travel to Kenya to serve God and the people of Kabula, Kenya.

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Countdown to Kenya

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The Kenya mission trip is coming up in 26 days and counting (see the timer in the right sidebar), so I am making lists and dragging out gear in preparation. Packing is a challenge for me; I tend to over-pack, yet always leave out something I need.

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This trip will be moderately roughing it, so sleeping bags, water purification gear, and batteries are on the list.

I usually don’t pack much in the way of batteries, because you can buy them in-country, but that is not the case in Kenya. Re-charging camera and phone batteries is possible in vehicles, but there are no wall sockets available in mud huts, apparently. I am obtaining an adapter to use C-cell batteries in my otoscope, so lots of those may be necessary; I don’t know how long they will last in the field.

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I am also obtaining a battery pack and solar charger to run my CPAP. My last mission trip without CPAP was in Nicaragua, camping in tents on the side of a mountain. I snored loudly enough to keep everyone else awake; I was miserable, and I came home with my legs swollen like tree trunks. Not gonna do that again!

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Please continue to pray for our team and the people of Kenya as we prepare to serve there.

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Photos courtesy of Anna Craig, MD

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Why I am a physician, why I am going to Kenya, and how you can help

This may be a little long, but I hope you will read through it.

As I have mentioned in previous posts, I will be joining a medical mission team to Kenya in February 2015. I have been asked quite a few questions about this plan, and I hope to answer some of them here.

I love practicing medicine, and I will forever be grateful for the opportunities that God has given me, the encouragement of my parents, the education provided by my schools and teachers, and the many patients (the true teachers) who entrusted their healthcare to me. I am a physician because that is God’s calling for me. I love interaction with and caring for patients; I love the intellectual challenge of making a diagnosis and treatment plan; I love the adrenaline rush of trauma and medical emergencies; I love teaching young doctors, nurses and others the art, as well as the science, of medical practice.

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I do not remember a time that I did not know that I would be a physician. I also knew early on that God wanted me to serve Him in parts of the world that did not have adequate medical care. The door to full time foreign missions has not (yet) opened, but in 2002 I began making short term mission trips with teams from various churches and organizations. I have had the opportunity to serve in Mexico, Honduras, Nicaragua, Cambodia and Viet Nam. Each mission has blessed me far more than any service I could render to people in those countries.

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So, why Kenya? This mission was started by medical students and led by Dr. Lisa Hodges in 2009. Dr. Hodges cannot make the trip this year, and I was offered the chance to participate. I will make the trip with three other doctors and several medical students. We will travel to Bungoma, in a rural and remote area of Kenya, to care for patients in scattered clinics set up in churches and schools. These people have very little access to health care except through medical mission teams from Western countries. Many of the diseases we will treat are only a memory or a note in a textbook in our country, like malaria, yellow fever, and tuberculosis.

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What about Ebola? The outbreak in Liberia, Guinea, and Sierra Leone is a tragedy, and has curtailed the number of medical missions to Africa. However, these countries are in western-most Africa; Kenya is in eastern Africa, on the coast of the Indian Ocean, and over 3000 miles away from the outbreak. Kenya closed its borders to travelers from those countries very early in the epidemic. With the fear about Ebola, however, many are choosing not to travel to Africa at all. Kenya, especially the small towns around Bungoma depend heavily on healthcare provided by volunteers. With those volunteers failing to come, treatable diseases are going untreated. Travel to health care is very expensive and reserved for those in the greatest need or those who can afford it.

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How can you help? With your prayers, of course, for me and my team members, as well as for the people of Kenya. Please ask God for His protection and guidance as we spread the Word of Jesus Christ and serve the medical needs of His under-served children.

This effort is funded entirely through contributions of concerned people like you. If you would like to participate in this mission through financial assistance, you may do so through PayPal, by clicking on the “Donate” button on this page. Your donation will pay for travel and lodging expenses, as well as medications and supplies. You may reach me by email at drfred56@gmail.com if you have any questions about how you can help.

Thank you in advance for your prayers.





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Getting ready for Kenya

It’s starting to look like the Kenya trip is a go for February 2015. I will be joining a team of 16 medical students, one resident (so far), and three other LSU School of Medicine faculty members in the Kenyan back-country for a month of medical clinics.

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Students from LSU have been doing these missions since 2009, and now the effort will give them academic credit, as a course in international medicine through the Family Medicine department.

The student organization, Support for Humanitarianism through Intercontinental Projects (SHIP), holds various fundraisers, but you can also make a tax-deductible donation through PayPal or by check here.

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When I figure out how to do it (help, Kevin!), I will place a widget in the sidebar with a PayPal “Donate” button. If you can’t donate to the cause, we, of course, desire your prayers for our team and the people we will serve in Kenya.