Today marks the halfway point in our eight-day community free clinic service. Although the first day seemed new and exciting, I grew frustrated and discouraged as the week wore on. By yesterday (Thursday, our 3rd day), I was almost angry. I went walking in the dark after dinner with Dr. Bonnie, 65, pediatrician from Alaska. This is her third clinic here, and she, too, was so discouraged by the end of yesterday that she confessed it might be her last. We took turns voicing our frustrations and analyzing our feelings. After about an hour of mutual venting, we seemed to reach the same disturbing question. We both realized that we were each wondering if these clinics were possibly doing more harm than good.
For my part, there were several issues. First of all, I was tired of the attitudes of the two male pediatricians, also in their 60's, who daily and constantly expressed their disdain and frustrations with these poor people who came to the clinic for free drugs and lab tests. It seems to me and to Bonnie that these quarterly clinics (which these very same docs organize!) are responsible for training these people to forego their regular medical care in hopes of obtaining the painkillers, HIV and TB tests, malaria and typhoid medicines, for free. Why then, in heaven's name, do these docs blame these innocent impoverished people for expecting such things? GGGRRRR.....
Secondly, I was discouraged by the endless trail of very sick people living in such filth and poverty. In the last four days, I have seen more respiratory infections with yellow nasal discharge, deep wet coughs, and chest congestion, than I have seen in my lifetime. Saddest of all were the numerous babies brought in each day with high fevers. I saw only one cloth "diaper" among them, as most wore dish cloths or nothing at all for diapers. The body odors of most adults were oppressive at times. I was saddened to see all the cast-off polyester and satin clothes that they wore, most likely sent here by Goodwill Industries and sold by for-profit used-clothing peddlers here. The kids were most often wearing dirty, raggd, winter coats and sweaters, and the adults were similarly dressed in layers and long-sleeved jackets.
Bonnie was troubled and torn by having to explain to patients why she would not, or could not in good conscience, hand out antibiotics for viral infections, and typhoid medicine just because someone thought they needed it again. She had been told by her interpreter during the last clinic that these people came here expecting medicine, and that the culture expected her to give it because she was a doctor. Yet Bonnie found herself unable to go along with this policy, which is why she took painstaking effort to try to educate each patient. She was trying to treat the Patient, not just the symptoms.
Furthermore, in my opinion, just holding our clinic on a regular basis tempts people with emergencies to waste precious time standing in our line outside all day instead of going straight to Kenyatta Hospital, which is where poor people must go. We have sent at least one person per day, including a feverish baby, straight to the hospital for emergency treatment AFTER they spent much of the day here. ARGHHH!!! One was a teenage boy that I assessed twice in two days for the doctor, and the second time was diagnosed with meningitis and sent on untreated. That boy was in agonizing pain, as I could see by the tension in his face and the look in his eyes. No telling how long he spent here waiting. Today, Terry the RN accompanied a 35-year old woman in shock to Kenyatta Hospital this morning. Terry returned with horror stories to tell about Kenyatta Hospital chaos at dinner. I had to quietly slip out to walk and pray. After walking in the dark alone for awhile, I decided to borrow the key to this office and use the old computer so that I could write my heart out. I needed solitude. I've got it now. But OK, enough about the clinic. More next week in the ongoing saga ...
For my part, there were several issues. First of all, I was tired of the attitudes of the two male pediatricians, also in their 60's, who daily and constantly expressed their disdain and frustrations with these poor people who came to the clinic for free drugs and lab tests. It seems to me and to Bonnie that these quarterly clinics (which these very same docs organize!) are responsible for training these people to forego their regular medical care in hopes of obtaining the painkillers, HIV and TB tests, malaria and typhoid medicines, for free. Why then, in heaven's name, do these docs blame these innocent impoverished people for expecting such things? GGGRRRR.....
Secondly, I was discouraged by the endless trail of very sick people living in such filth and poverty. In the last four days, I have seen more respiratory infections with yellow nasal discharge, deep wet coughs, and chest congestion, than I have seen in my lifetime. Saddest of all were the numerous babies brought in each day with high fevers. I saw only one cloth "diaper" among them, as most wore dish cloths or nothing at all for diapers. The body odors of most adults were oppressive at times. I was saddened to see all the cast-off polyester and satin clothes that they wore, most likely sent here by Goodwill Industries and sold by for-profit used-clothing peddlers here. The kids were most often wearing dirty, raggd, winter coats and sweaters, and the adults were similarly dressed in layers and long-sleeved jackets.
Bonnie was troubled and torn by having to explain to patients why she would not, or could not in good conscience, hand out antibiotics for viral infections, and typhoid medicine just because someone thought they needed it again. She had been told by her interpreter during the last clinic that these people came here expecting medicine, and that the culture expected her to give it because she was a doctor. Yet Bonnie found herself unable to go along with this policy, which is why she took painstaking effort to try to educate each patient. She was trying to treat the Patient, not just the symptoms.
Furthermore, in my opinion, just holding our clinic on a regular basis tempts people with emergencies to waste precious time standing in our line outside all day instead of going straight to Kenyatta Hospital, which is where poor people must go. We have sent at least one person per day, including a feverish baby, straight to the hospital for emergency treatment AFTER they spent much of the day here. ARGHHH!!! One was a teenage boy that I assessed twice in two days for the doctor, and the second time was diagnosed with meningitis and sent on untreated. That boy was in agonizing pain, as I could see by the tension in his face and the look in his eyes. No telling how long he spent here waiting. Today, Terry the RN accompanied a 35-year old woman in shock to Kenyatta Hospital this morning. Terry returned with horror stories to tell about Kenyatta Hospital chaos at dinner. I had to quietly slip out to walk and pray. After walking in the dark alone for awhile, I decided to borrow the key to this office and use the old computer so that I could write my heart out. I needed solitude. I've got it now. But OK, enough about the clinic. More next week in the ongoing saga ...
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