Sidai Outreach Day

Mama Kelsey is working at an orphanage called Sidai; it is located in the Mathare slum in Ngong. There are 25 children who live at the orphanage but there are up to 100 that take meals there, come for classes or generally hang about. Yesterday myself and two other volunteer nurses spent the afternoon at Sidai doing health assessments on the kids; Grace called it our "outreach day".

The whole idea was actually my mum's, she wondered if the kids should be checked for lice and other health ailments. From there we planned the afternoon and ended up getting the hospital to supply us with some supplements and equipment and such. The orphanage staff were really keen and thought it was a great idea. They were there the whole time helping us keep the kids under control and filling us in on whatever health history they knew for the children.

Casey and Barbette were my partners in crime; they are both nurses from the US who arrived to volunteer at the same time as my mum. After working for the morning at the hospital we packed up out things and headed down to the slum. Sidai itself is located in two small aluminum shacks, with dirt floors and no electricity. The larger room has a couch and desks for the children to take lessons at. We entered and began setting up under 15 pairs of watchful eyes. The children were all very excited to see what we were doing (and when they found out they would get a cookie at the end, they were even more thrilled).

So the children lined up and passed by each of us in turn. Barbette gave them Vitamin A supplements and Albuzol to treat intestinal parasites (Grace tells me they should be treated every three months regardless of a diagnosis, but this often doesn't happen). I'm pretty sure the tablets (which have to be chewed) don't taste good but the kids loved them; they just wanted to suck on them despite all our efforts to get them to chew.

Next they came to me and I did a quick little health assessment - listened to their lungs, felt their bellies, checked for lice, jaundice, rashes and scratches etc. Many of them looked completely perplexed by my stethoscope and watched me with great interest. They loved the part where I looked through their hair and got them to stick out their tongue. Of course there were a few who looked shy or didn't want to look anywhere but the ground... and the odd one that was downright frightened of the scary white girl.

Finally they finished up by seeing Casey and having their height and weight taken. Then of course the promised cookie - cheap cookies from Nakumatt could never bring such delight to children in Canada as they seemed to here! There were even a few kids who tried to sneak back in the line and go again, I think they liked the attention as much as the cookie!

We saw 64 children in total and overall I was surprised that most of the kids were in pretty good health. I expected to hear more rattly chests or even wheezes (the classrooms are very smoky and I can't understand how more of the kids don't have asthma), but heard nothing but clear breath sounds. I found no head lice (but mum gave them some Nix anyway and we explained how and when to use it). There were a few kids with scratches and cuts that we put some polysporin on. I did notice that many of them seemed pale and I wonder about their iron levels - the biggest source of iron in the diet here is from green leafy vegetables, which these kids don't get. I'm going to have to look into this.

I noticed two children who I highly suspect of having Fetal Alcohol Syndrome, which wouldn't be uncommon given the population the children are coming from. However when my mum described it to the teachers later, they had never even heard of it (even Grace, a nutritionist, had never heard of it). The teachers though felt it explained a lot about these children when we said FAS can make learning very difficult for the children. Even though these kids will never get the kind of education resources that might be available to them in Canada, the teachers seemed very conscientious and I think this knowledge may help them to have more understanding and maybe more patience with these little ones.

Finally HIV; I knew it would come up. There are two little boys who the staff know are HIV +, but both looked remarkably healthy (other than being thin and small for their age). The one little boy was especially cute and playful with me and mum says he is very bright. His mother is refusing all Western medicine for him as she believes Masaai medicine is better. I'm not quite sure but it sounds like the staff may have been taking him to the hospital for treatment at some point without her knowing. For now he is happy and active. Then there was one boy who, even from across the room, I could tell that he was sick. When he finally came up to me, very shy but very polite, I could see all the signs of full blown AIDS. The staff said his mother takes him to the AIDS clinic at Kenyatta hospital but hasn't been going lately (they're not entirely sure why but finances could be the issue, although treatment is free, the matatu fare to get there could easily be 100/= which the mother can't afford). I am pretty sure the boy can be treated in Ngong Hospital, which, being a government hospital, will provide all care as well as medications free of charge. We are working out the details so we can hopefully get him seen pretty soon and started on some treatment.

Overall the health day went really well - the children were thoroughly entertained by it all, the staff were very appreciate and we all left feeling like we had accomplished something. The orphanage is hot and sweaty and cramped and dark but I didn't mind - in fact I felt no nostalgia at all for my air conditioned, pristinely sanitized Western hospitals.