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Published: February 28th 2009
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On Tuesday 17 February we were privileged to accompany a team of healthcare workers from Arsim Dispensary to two nearby villages - Sidai and Rosso. All week long, teams are providing medicine to people to help them combat, and eradicate this disease.
Sidai is the first site that Cheryl and I visited with the team. Here are some photos of the Sidai Clinic, the Sidai Waiting Room and the Parking Lot. Sidai (which means ostrich in Samburu) is one of two mobile clinics sponsored by our church. The other is at a Rendille settlement called Red Rock or Soito Nanyukuo and is located about one hour from Arsim.
I’m not so sure that our presence was particularly helpful to the dispensary staff, especially among the very young. The under two crowd saw our ghostly white skin and thought the worst. The slightly older kids, say age three on up, couldn’t keep their hands off us. They had to touch our hands (shaking was great fun) feel the hair on our arms (Samburu people have no hair on their arms and legs) and do anything to make sure that the “white” doesn’t rub off.
The little ones screamed bloody
murder if Cheryl tried to give them their liquid medicine. She resorted to handing it to Mom who then gave the child the medicine. It was even more pronounced if I came near them. I started across the “waiting room” and a little girl was at the other side. She saw me, her eyes became as big as saucers and she quickly changed direction so as to not cross my path. Tragedy averted.
Trachoma is a disease that affects the eyes and is of near epidemic proportions in rural Kenya. It comes from unsanitary living conditions, particularly from living in such close proximity with the animals. I’ve seen Gloria treat a young man in his late teens or early 20’s in her eye clinic. He had a white growth over his pupil so that he was unable to see out of most of the eye. She treated him with oral antibiotics, drops to dilate the pupil so he could see around the growth (which then means he has to wear sun glasses - he looked cool, but it’s uncharacteristic of Samburu people), an antibiotic salve, ibuprofen for the pain, more drops, more pills … Still he’s going blind.
The people here live in clusters of stick huts covered with leaves, cardboard and (during the rainy season) plastic sheeting. The plastic only comes out during the two weeks of rain, since to put it up at other times of the year; it would be destroyed by the sun’s rays.
The Samburu people are nomadic, herding people as no crops really grow here. There are lots of Acacia trees and some scrub brush for their goats, sheep, cattle, donkeys and camels to graze upon. The people are able to sell meat, milk, wool and hides from their animals in order to buy a few vegetables, some cloth and other items for their daily sustenance.
Acacia trees produce a curly pod that is very nutritious for the animals. The pods taste kind of like a bean and can be eaten by humans as well. Generally, the people do not eat the pods, but toward the end of the dry season, it may be their only option. When they do, they crush the pods and make kind of a stew out of the beans.
Since the animals are their sole source of livelihood, they keep them close at hand.
the "stick"
This is the infamous "stick" that has been sticking us They keep them in pens next to the house at night and herd them into the pastures during the day. It’s this close proximity to the animals that causes the infection. They are exposed to the manure and flies are everywhere.
The vaccination program is to cover a three-year period. It has been started in some other areas a year ago and 2009 is the first year for the Samburu people. The adults and larger children are given Azythromycin tablets, dosage according to size. The smaller children are given a cup of liquid Azythromycin (again according to height) and the infants get a tetracycline hydrochloride ointment to be administered by their parents.
The reason height is the standard is because people just don’t know how old they are. Age is not an important determinant in their society. Unless something else remarkable happened the year a child is born, the event is not noted.
Therefore, the “stick” comes into play. It’s a 1x3 with magic marker lines to indicate how many cc’s of liquid for the small children and how many tablet for the taller ones. The theory is that they all grow at roughly the same rate. Since they don’t have age to go by, this is the best they can do.
The Ministry of Health has estimated the population based on the 1999 census projected forward at a 2.8 % annual growth rate. However, the actual growth rate in the area covered by the Arsim Dispensary is probably over 6%. Therefore, they only provided enough medicine for X number of people which is severely below the amount needed to cover the population.
The government set a goal of 80% coverage with the Trachoma medication for the week of distribution. By the time Gloria compiled her reports for the first five days of distribution when were ready to leave on safari, she had reached 160% of the population. She and her staff started on Monday and ran out of medication on Wednesday morning. She still had the rest of Wednesday through Sunday to distribute medicine. With an emergency phone call to the government wizards, additional medication arrived Wednesday afternoon just as a dozen or so people showed up at her dispensary to be treated. Had the shipment not arrived, she would have had to turn people away until more antibiotics arrived. Another tragedy averted.
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