Hospital visits

Every week we visit our clients who are hospitalized. The public district hospital, also known as “Russia”, was built in the 1960’s by (you guessed it) the Soviets and is quite similar to the hospitals I saw in Cuba – from the cement block architecture, to the peeling paint on the walls, to the open wards, with 10 – 20 beds per room. However, Kenya’s public hospital is slightly worse. There is visible dirt on the floors and walls, flies everywhere, almost overpowering smells coming from the open toilets just off the wards, and the degree of illness – emaciated, near comatose patients in most beds – is chilling. Not surprisingly we try and do everything possible to keep patients out of the hospital – even if they are sick enough to merit admission in another world. I think as much disease is caught as treated here – a patient with active TB will be sitting next to a patient with advanced AIDS. It is malaria season now – I diagnosed 6 patients with it just yesterday – and it often brings out other diseases in our already debilitated patients. The quality of medicine practiced is, at times, frightening – tests not done for days, treatments not given (sometimes because a family just can’t afford to buy the medication needed), diagnoses missed. The care on the ward is run by clinical officers who are rotating through for three months – with less training than most medical students in the U.S. so in some ways the level of care is no surprise. We visit patients as much as anything to check that they are being evaluated and treated appropriately and to either bring or help their families buy the medications they need. What is really remarkable about all this, is one of the clinical officers from our clinic was telling me how much better it is now – it is rare to see two patients to a bed (except in the pediatrics ward where that is standard), AIDS patients are actually cared for (rather than being left in the corner, denied beds, and not touched by any provider for fear of contracting the disease), food is provided for patients three times a day, and the bathrooms are actually cleaner than they used to be. The picture above is from the outside (looks pretty nice from here!) and two of the clinical officers I have been working with.

The private hospitals are a different story - still definitely not what I am used to, but at least not the public health nightmare that the district hospital is. Not everyone here is suffering the level of poverty I am seeing so often.