Out of Africa

Okay, back to the blog–I was unable to upload photos while in Kenya, so I posted on Facebook exclusively. Now that I am back home, I can tell the story of the past month with illustrations.

In late January, the SHIP team from LSU School of Medicine in Shreveport traveled to western Kenya to hold mobile clinics in rural villages in Bungoma and Kakamega counties. Our team was composed of faculty (Drs. Don and Amy Givler, Conway Family Medicine; and myself), four resident physicians (Dr. Nicole Jones, Pediatrics; Drs. Yemesi Adesida and Aiyasawmi Doraijan, Med/Peds; and Dr. Timothy “Tip” Rugile, Rural Family Medicine), medical students Rob Ross, Victoria Bamburg, Dieu Doan, Ariel Osorio, Miriam Hankins, Emily Barsley, Kelly Bihm, Rachel Noto, Andrew Murphy, and physician assistant Kelsey Devine. Mid-month Dr. Amy and the medical students went home, and were replaced by Dr. Michael Harper (LSU Family Medicine-Shreveport); medical students Britton Beatrous, Julio Vega, Rachel Strength, Victoria Luraguiz, and Richie Diaz; and registered nurse Melaine Wall Craig.

We were based at the home of Bishop Reuben and “Mama” Betty Lubanga, in the village of Kabula, just south of Bungoma, Kenya. Bishop Reuben’s organization, ICODEI/Volunteer Kenya, is our sponsor in the country. The organization provides our food and housing, sets up our clinic sites, and arranges for transportation and translators. The clinic coordinator, “Mama” Joyce Wasike, is the day-to-day ramrod and driving force.

Mornings started with breakfast, and a presentation by a medical student on a medical topic related to Kenya.

After breakfast, we headed over to the clinic building, where we usually saw several patients, then loaded up our pharmacy and equipment to travel to the day’s mobile clinic site.

We went to a different site each day, usually a rural church or a village community center. In one case, it was on the lawn of a private home. If there was space and shade available, we set up stations outside. Some sites had neither, and we set up inside. The low buildings with metal roofs get pretty hot up in the day, so outside in the shade was preferred.

Each student had a station to see patients, and a translator. After obtaining a history, performing a physical exam, and formulating a differential diagnosis and plan, the student daktaris would present the case to a faculty member. When the diagnosis and plan were confirmed, the patient received treatment, including medications from the pharmacy. Our resident physicians saw patients on their own, but often consulted faculty, as well.

Degenerative joint disease (old, worn out joints) is very common in our patient population, and we often inject joints to give the patient some temporary relief from their pain.

On weekends, we often did the tourist thing, and visited places like Samich Resort, on the escarpment overlooking the Great Rift Valley;

or Lake Victoria;

or even the caves of Mount Elgon.

Several team members elected to do a game safari to Lake Nakuru and Masai Mara Game Reserves.

We are all now home in the States, but as always, I returned a different person. I praise God for the opportunity to serve others, for His glory, in Kenya, and wherever the next opportunity takes me. I am just waiting for Him to open the door.

Kenya 2018–Clinic Day 1

Habari from Kabula, Kenya!

Our first day of clinic went really well. Our site was at the home (on the grounds) of Mrs. Mable Walwaula, my favorite. The grounds are peaceful and cool. And Mrs. Mable cooked lunch for us!

We have a large group this half of the month, with 18 medical students, residents and faculty. Add to that translators, a nurse, a pharmacist and a clinical officer, and you have a transportation problem. Everyone pitched in and made it all work today. We shall see if this continues to work, or if we need to hire another vehicle and driver.

We had approximately 91 patient contacts today.

Please pray for us as we continue to serve the people of rural western Kenya.

I can’t get a photo to upload, so none for tonight. More tomorrow.

LSU/SHIP Kenya 2018

The time to leave for Kenya is rapidly approaching. LSUHSC faculty, residents, and students, through Support for Humanitarianism through Intercontinental Projects (SHIP), will again be traveling to western Kenya to minister to the medically under-served in the area. We will be partnering with ICODEI, a Kenyan organization directed by Bishop Reuben Lubanga.

This year’s team will include four LSU faculty members, Dr. Don Givler, Dr. Amy Givler, Dr. Michael Harper, and myself; four residents from the Pediatrics, Med/Peds, and Rural Family Medicine programs; sixteen (if I counted correctly) medical students from the 3rd and 4th year classes; and a registered nurse. We are supported by a great team at home at LSUHSC, as well.

This will be my fourth visit to the Bungoma, Kenya area. I am excited by this year’s team. Our primary purpose will be medical outreach to the under-served population around Bungoma. The residents and students will have an opportunity to learn about medicine in a different culture, under very different circumstances, and with new challenges.

I also am excited about seeing my Kenyan family in Kabula–Bishop Reuben, his wife Mama Betty, our clinic director Mama Joyce Wasike, and their families. They bless us with their love, hospitality, and wisdom.

I ask for your prayers for our team as we travel and minister.

I will be posting more in the days ahead, and hopefully in Kenya, as well.

Time to leave for Kenya–prayers appreciated!

Tomorrow, January 27, the LSU/SHIP team will be leaving Louisiana for Kenya 2017!

On our team this year will be myself, Drs. Don and Amy Givler, and Dr. Ragsdale; Pediatrics residents Vilasini Rekhala, Truc Doan, Nicole Jones, and Teresa Do, as well as Rural Family Medicine resident Zohreen Bheriani; and medical students Lisa McDivitt, Melissa Davis, Morgan Bankston, Blair Stevens, Hanna Sams, Tischelle Gatlin, Rachel Strength, and Maria Luraquiz. Dotsy Baxter (Dr. Don’s sister) and Karen Do, RN (Teresa’s sister) finish out this fine team. Some will be in country for the first half of the month of February, others the second half; 8 of us (the Iron Doctors!) will be there the whole month.

As in previous years, we will be staying with Bishop Reuben and Betty Lubanga. Their home, and the ICODEI compound, are located in Kabula, a few kilometers south of Bungoma, Kenya. We will travel daily from there to outlying villages, setting up a mobile clinic to serve the needs of Kenyans in the area. We will be led by Mama Joyce Wasike, with her team of Kenyan clinical officers, nurses, pharmacists, and translators.

I am excited about our team, seeing old friends and meeting new ones, and ministering to the medical needs of rural Kenyans around Bungoma. Please pray for our team as we travel, and as we serve and learn in Kenya.

I will be posting daily if possible, but of course this will depend on electrical power and internet access being available.


Happy Leap Day!

I am back from Africa, after a very busy tour of western Kenya with the SHIP team from LSU School of Medicine in Shreveport. Drs. Don and Amy Givler and I had the opportunity to supervise a fantastic group of residents and medical students from LSU, providing mobile health clinics at 18 sites over the month of February.

After a 45 hour trip home (about half of that layovers in airports), we arrived Saturday night, and I have spent most of my time since then sleeping, doing laundry, and trying to recover from the jet lag.

It is a bit odd to have missed a third of our winter in Louisiana. Some of the trees are beginning to green up, and their are blooms on the Japanese magnolias and redbuds, and even a few azaleas are blooming. Did I miss much?

I will probably have more to say here about what the month in Africa meant to me personally. In the mean time, I am getting back in the groove of my life here in the good ol’ USA.


Kenya update 2/25/16

Greetings from the LSU/SHIP team in Kenya!

Today is our last day at the ICODEI compound at Kabula, Bungoma County, Western Kenya. We went “not far” down the road to Bulimbo, a revisit to the unfinished clinic building in the Malandisia neighborhood. The building was unchanged, in spite of the local promises of a completed building.

Organization was a bit lacking with Mama Joyce in Nairobi, and only a few patients showed up for our clinic. Some members of the team took the opportunity to organize the pharmacy. We ended up with 20 patients seen, and came home early to pack.

The rest of the afternoon has been spent relaxing in the shade, playing ping-pong, and watching the weaver birds begin nest-building in one of the large trees in the compound.

Time to go home. A bit bittersweet, as I look forward to being with friends and family at home, but I will miss our friends and family here in Kenya. I will miss awakening to the rooster crowing and the sound of the community water pump outside my window. I will miss the amazing breakfast of fresh mangoes, bananas and papayas. I will miss the camaraderie of the team of US volunteers and Kenyan healthcare workers and translators who have bonded into a cohesive unit (if not a well-oiled machine). I will miss chai time in the evenings, and the lively discussions at dinner.

The LSU/SHIP team came to Kenya to provide needed healthcare to a grossly underserved people, and we have done that within our limitations. We also came to learn, and the Kenyan people have taught us not only about tropical medicine in a third world country, but about tenacity and perserverence in the face of adversity and a hostile environment as well.

For me, this adventure was also about sharing the love of Jesus Christ in Kenya. I pray that I have done that to the best of my ability. The Gospel is shared widely in Kenya by Kenyans as well as missionaries; I see my job as demonstrating the love of my fellow man that Jesus taught. And I give all the glory to my Heavenly Father, lest I do anything for the praise of others.

Please pray for our team as we began the journey home tomorrow (it is a bit far!). We will drive to Kisumu, then begin our flight, with stops in Nairobi, Amsterdam, and Atlanta, and arrive in Shreveport (Monroe for Dr. Don) Saturday night.

Asante sana for all your prayers and support!


Kenya update 2/24/16

Habari from the LSU/SHIP team in western Kenya!

Today’s mobile clinic site was at the church in Shibuli. It was, as Jackson, our driver, says, “a bit far.”

Every morning I ask Jackson how far it is to the day’s clinic site. Most Kenyans will reply with a time, not a distance, but Jackson will usually reply, “It’s not so far”, which generally translates to about 30 minutes. Sometimes his reply is “It’s not too far”, which turns out to be about an hour. This morning he told me, “It’s a bit far,” and about an hour and a half later, he told me with a grin, “I told you it was far.”

Our patient load today was rather light, which was something of a blessing–we are running low on medications, and were completely out of basics like paracetamol (acetaminophen or Tylenol at home), ibuprofen, and multivitamins. Jackson was sent on a quest for meds, and returned later with most of what we needed. A trip to our chemist in Bungoma filled out our needs for the last clinic tomorrow.

Perhaps more later. It is difficult to type while fighting off these malaria-laden mosquitoes!

Kenya update 2/22/16

Habari from the LSU/ SHIP team in Kenya!

Today’s mobile clinic was located at the church at Shiengela, further out than any previous clinic site. This church is literally built on a rock, with the ground sloping steeply away in all directions. A gnarled old bougainvillea stands near the front door.


In addition to the usual malaria and degenerative joint disease, we saw a lady who was a lifetime smoker with a cough, tachypnea and absent breath sounds on one side; we sent this lady to the hospital for an xray and treatment. One little girl had congenital microphthalmia, probably due to a congenital infection. Another lady had a very large, hard, mobile mass in her abdomen which had been there for several years. It didn’t seem to be attached to any organs, unless it was mesenteric in origin.

On the way home, we had an interesting encounter with the local police outside Butere. They stopped both vehicles, and insisted that we had been doing 59 kph in a 50 kph zone. The usual speed limit is 80 kph, and there are no speed limit signs (or any other road signs) on most Kenyan roads. Initially they demanded cash, and when refused, insisted that the drivers take the vehicles to the police station. After a lot of back and forth, we were allowed to continue our trip home.

Only three more clinic days left. Tomorrow’s clinic is at Siloba. We appreciate your prayers and support.

Usiku mwema!

Kenya update 2/18/2016

Greetings from the LSU/SHIP team in Kenya!

Our 14th mobile clinic today was at the church at Emakale; again we went far south of home, past Eshitari (which I thought was on the edge of nowhere) for several miles. The county has been “improving” the road, and crushed rock was piled in the road, taking up 2/3 of the roadway; we were forced to drive in the ditch for the last five miles or so.

Our patient mix was about the same today, with no really unusual diagnoses. We did see one lady with a blood glucose of 455; she had no idea that she might be diabetic. There were also a few patients with elevated blood pressures; all of these were referred to the hospital for evaluation and management.

Random observation–I saw a new Ford pickup in Mumia today. This was unusual, because almost all personal vehicles in Kenya are Japanese; most are Toyotas, with a few Hondas and Isuzus. All motorcycles are Chinese. All tractors are American-made, mostly Ford/New Holland with an occasional Case thrown in.

A couple of days ago, Mary asked me what I missed the most at home. Yes, I knew the correct answer to that question! Someone else (a Kenyan) asked me the same question today. Besides friends and family, I miss air conditioning, decent roads, seasoned food, and my own bed. I will probably sous vide a nice, thick ribeye on the first day I get home. I could live in Kenya, but there are many huge advantages to living in the United States. Living in a third world country for a short while certainly makes me grateful for the blessings of our country.

On to Lunao tomorrow! Only five more clinic days left. Thank you for your continued support and prayers!

Melissa is definitely a kid person

Melissa is definitely a kid person

Kenya Update 2/17/16

Greetings from the LSU/SHIP team in Western Kenya!

We are averaging over 100 patients a day this week, so we are going through medications like crazy. Therefore, another stop at our supplier in Bungoma.

Another hot and dusty day of fun! Our mobile clinic today was in Chebukwa, north of Bungoma, at a clinic building built by Bishop Tom __. The building would not hold all of our team, so we set up the pharmacy on the front porch, then three patient stations on the inside, with three more on the outside.

There were more children with malaria and jiggers, and more adults with the musculoskeletal aches and pains of a life of hard labor. There was one older lady with congestive heart failure, probably secondary to rheumatic valvular disease. Another young lady had nephrotic syndrome, and had massive ascites (fluid in the abdominal cavity), pleural effusions, and extensive peripheral edema.

All of these problems we managed with the limited resources available to us. Sometimes our efforts seem inadequate (to us). There is so much more we could do for some of our patients here if we had the resources available in the United States; learning to do the best we can with what we have, and accepting that we have improved these peoples’ lives at least in a small way, is part of the Kenya experience.

Please continue to pray for our team and the folks we are striving to help in Kenya.