Saturday, September 25, 2010

Life in Karero

Our life in Karero sort of goes like this:

We wake around 7:30am to the sounds of one of the following:
1)      1) KiMaasai being sung or spoken directly outside of our tent
2)      2)  Children singing at the adjacent primary school
3)      3) Donkeys walking right next to the tent in route to deposit our daily water supply in a large basin behind the clinic

A wonderful woman brings us tea every morning which we enjoy with our very traditional meal…PB&J.  We have introduced PB&J to a few of the Maasai men who seem to like it, but always note that it is very sweet.  I think they prefer roasted goat meat and goat soup as they enjoyed it one morning with much delight. Mike has enjoyed many types of goat soup with the guys (i.e. goat soup made from goat intestines, goat ribs, and goat head). I always come close, but graciously decline (just can’t do it!).

We get to work after breakfast.  Mike and I in typical American/”get to work” fashion set out to work right away.  We are soon joined by Tyson, Kimare (aka “simba”…a nickname he recently gave himself), and Baba Nanoia (named so after his first born “Nanoia”). You will have to excuse my spelling! Several other Maasai men and women stop by through the day to help with work or to visit. Work consists of endless scraping, sweeping, mopping, building, and painting.  I cannot begin to explain how much dust there is in the bush.  The other day, the wind and dust blew so hard that it blew down a metal kitchen at the school.  The dust is 2-3 inches deep in some areas.  This makes it difficult when you are trying to paint the floor!  Anyway, I work with the men doing the repairs, but am often interrupted to also assist with patient care and teaching.  The other day I was in my work clothes, mask and goggles, covered in dirt, bugs, and God knows what else, when I was asked to see a woman who was possibly having a miscarriage…quite a contrast of work, but it keeps me on my toes and I love it.  

The clinic is pretty much open 24 hours a day.  Things are starting to pick up and we are trying to help bring it back to life. It has been wonderful to work alongside members of the community.  The hope is really to empower the community to take ownership of and pride in this clinic.  We will see.
Joyce, Faith and her son, Alex, all live at the clinic as they await suitable housing to be built.  Ester is the laboratory technician.  Faith is the medical assistant who also helps with intake and Maasia translation.  Joyce is the new nurse who has been hired to see patients and is quickly taking ownership of clinic.  I will have to postpone an explanation of the Kenyan healthcare system, particularly roles of healthcare workers, as it would take way too long and I am still trying to understand (Alas, a “system” just as confusing and crazy as the American healthcare system!).   We exchange ideas and I have been doing some teaching. I have given her my old Sanford Guide to explain all about prescribing antibiotics, antiparasitics, etc.  Thank you to the entire Edmonds Family Medicine team, the Karero clinic is greatly benefitting from a huge donation of medical supplies. 

We break for lunch sometime between 1 and 3, depending on the meal (beans and rice vs. slaughtering a goat).  We work a bit after lunch until the early evening.  Every day varies depending on what is going on in the community, available supplies at the clinic, and tasks that need to be accomplished and how that is affected by supply (i.e. whether we have water that day).  Unlike in America, you can never assume or take for granted that you have anything, such as light or water. 

During our week at the clinic, there has been a lot of activity in the surrounding Karero Maasai community.  I cannot really explain our “typical” day in Karero without interjecting some of the week’s headlines.  Unfortunately, much of the activity has been that of violence among the Maasai men resulting in several community meetings. The Maasai judicial system works like this:
1)     1)  an event/crime  occurs such as a fight or theft *
2)     2) The next day, there is a meeting of all the Maasai men (only those who have been circumcised and older) in which all members have an opportunity to voice their opinions
3)     3) The elders then decide the punishment, which usually consists of a payment of Kenyan shillings, animals, and beer given to the victim’s family (the beer is usually for the elders)
*Note, the crime or event only includes those in which men are the victims.  For instance, there is no “trial” or punishment if a man beats his wife or if a woman is raped.  (Needless to say, this is a bit frustrating!)

I am acutely aware of the happenings in the community, as I have been seeing and treating the victims in the clinic.  The first night we were there, Joyce had left for the evening and the only people at the clinic were Faith, Alex, Mike and me.   Mike and I were just about to go to sleep when a few Maasai men and women came to the clinic.  There had been a fight and one of the men had been beaten over the head with a club, which resulted in a large open wound on his head.  Luckily, Faith could translate and I ended up suturing this guy’s head in the dark with a few broken flashlights to assist me.  Looking back, it was quite a comical scene...
 Picture this: a dark room in the middle of the bush with one broken flashlight that kept going on and off and one that continued to run out of batteries and a white American girl who speaks about 7 Maasai words (“thank you,” “how are you,” “yes”, and “no”) with an intoxicated patient who refused local anesthesia and insisted on moving his head every 2 minutes.  Ahh, it was a frustrating comedy to say the least.  Thankfully, I was able to repair his wound with ten stitches and not stick myself in the process!

The other event was that a man whipped a child with a branch across his face and the poor kid presented with a facial wound and swelling.  We bandaged him up and the man is awaiting punishment. 

These sort of violent activities are not acceptable and the community seems to take action quickly in order to establish punishment.  I hope that soon that their legal code will also apply to women. 

Mike and I sleep in tent outside of the clinic.  We prefer camping in our cozy tent to sleeping inside the clinic.  We are guarded through the night by our Maasai warrior watchman, Baba Nanoia.  Baba Nanoia (aka “leg guy” as he has a deformed foot from falling in a fire as a child and everyone calls him “leg guy” without question of insult) protects us through the night from the hyenas, donkeys, lions, and other animals that I try not to think about.  Despite his deformity, he was one of the best and fearless warriors of his tribe.   He is quickly becoming our good friend, teaching us KiMaasai language and learning some of our American slang.  We really enjoy spending time with him through the day and wish we were able to communicate better.  His KiSwahilli is a bit limited and our KiMaasai is very limited.  Despite the language barrier, we feel close to him and he protects us well.  In a sincere moment yesterday, he generously offered to give us one of his daughters as a gift.  I know this sounds absolutely crazy, but, apparently, Maasai families will sometimes give one of their children as a gift to a woman.  As much you know I would love to adopt a child from Africa, I could never imagine taking a child from his or her family.  We graciously declined…and were a bit speechless as I am not sure the proper response to this sort of offering. 

So, then, we usually fall asleep to the sound of donkeys and birds. I often wake in the middle of the night to the sound of cackling hyenas, which, if I were to think about it too closely, would scare the crap out of me!  Don’t worry mom and dad, I promise we are safe! 

So, that is a summary of our  “typical” day/week.  As you can tell amid all the digressions, there is nothing routine or typical about it.   We are in Mali Tisa and Namanga for a few days to gather more supplies before we head back out for another "week"...remember, no such as thing as time in Kenya!  

Thank you to all of you who have supported us with your generous donations. You are helping to provide a functioning clinic to this wonderful community.


  1. I love hearing about the medico-judicial interactions. Wish I was there to observe these trials! Do you see women victims of violence at the clinic or do they tend to stay home and tend to their own injuries?

  2. Lay-a-beds! Are there no roosters in Karero? Can't hear a rooster crowing without it stirring up memories of Africa. LOL at the dust. I assume you haven't gone very far riding on the back of a motorcycle yet. It will take DAYS to get the dust out of your hair, clothes, pores of your skin...

    Forget the hyenas, treating a miscarrying woman deep in the bush with not much equipment would scare the crap out of me!

    Thanks for keeping up this great blog