Ngong Healthcare Centre

I have now been volunteering at the Ngong Healthcare Centre for just over a week. I would love to say that I'm working there, but really the term working would be a bit of an exaggeration. Mostly I follow the nurses around and pester them with a million questions. They don't seem to mind though... the nurses are all really friendly and seem to be wildly entertained when I tell them about how different hospitals in Canada are (and life in general).

The hospital itself is a government run facility housed in a fairly austere building in the hills above the town itself. Being government run they are lucky in that they have a constant source of funding - this however doesn't always translate into a constant source of supplies. Medications frequently run out and patients are forced to supply their own medications from a pharmacy in town (at a cost to the patient). As well the sterilization machine has been out of service for a week so there are no dressing kits and the birthing kits are quickly running out. I keep asking what will happen when there are no more birthing kits and the replies seem to run along the lines of "we'll make do".

During the day patients are seen on an outpatient basis by clinic officers (which from what I can tell are sort of like Residents in Canada, but there is only one supervising doctor for a number of facilities). Patients pay 30 shillings to be seen which includes the consultation as well as any procedures or medications needed. 30 shillings translates to roughly $0.50 CAD but still it is out of reach for many patients.

Other services at the hospital are offered free of charge. These include VCT (Voluntary Counselling and Testing, for HIV), CCC (Complete Care Clinic, also for HIV/AIDS), TB clinic, diabetes clinic, nutrition, physiotherapy, pre-natal clinic, Family Planning Clinic, PMTCT (Prevention of Mother To Child Transmission, of HIV), maternity and CWC (Child Welfare Clinic, providing vaccinations and counselling for mothers).

As well there is a ward for inpatients which includes six beds. Most of my days at the hospital the wards have been completely empty, although today there were three children admitted all with malaria and severe dehydration.

I have been spending most of my time working in the Pre-natal/ Family Planning clinics and in the Child Welfare Clinic. Although I'm fairly useless in counselling (since my Swahili is pretty much nil), I am helping with assessing mothers and babies, as well as providing medications and vaccinations. I'm finding the work fascinating, even the maternity ward, which in Canada I try to avoid at all costs.

On my first day in the Child Welfare clinic the nurse was showing me the schedule for child vaccinations. I told her I had never given a BCG vaccine (a vaccine for Tuberculosis which leaves a scar on the arm). All the nurses were shocked that we don't routinely vaccinate our children for TB so I tried to explain that although TB exists in isolated populations in Canada, it is not endemic and so now a threat to the general population. They all looked shocked, and quickly pulled up my sleeve to check for my BCG scar. When they couldn't find it they had a quick deliberation in Swahili and then quickly turned back to me and offered to vaccinate me right then and there. That has started an ongoing discussion of the differences not only between health care in Kenya and Canada but also between the types of conditions and diseases we see. After describing many of the conditions we see in Canada (heart disease, hypertension, diabetes, obesity, etc) the nurses all nodded knowingly and one stated "oh, rich diseases".

Overall, the first two days at the hospital I was overwhelmed by the differences between home and here. Now, as I am learning more, I am finding more and more similarities; although the facility is sparse and the supplies limited, the knowledge and ideal for care is very similar.