My Final Post

We have now turned over our clinic, counseling/medical/HIV/AIDS/obgyn and all Mission Statements and all files to The Chief of Medicine at the hospital. We all had sadness while turning over the fruits of our labor. We shared building the clinic from square one to a functioning clinic that hundreds of people now welcomed into their lives. How humbling this was for the four of us. Our first day off was wonderful, we all woke up at 6 am. by habit, then we all slept till 11 pm that night. Two days left, we chose to travel to the ocean. Three buses later and several hours, we arrived at the Indian Ocean. We stayed there as long as possible, swimming, playing by the sea side, till we had to return by bus and return to Narobi. Tomorrow we pack and prepare for the car to arrive. Should arrive in NYC past the date line being ahead of North America, on the 26th, sh. When I am in Manhattan, I will call everyone.

In My Heart,
Joe

Candians watching the sunset

This is the sunset we watched last night. We have not had a full day off from the clinics to date.
The demand for clinic time has overwhelmed the four of us. 6 am. till 7 pm. Long hours, and at times we feel that we are not helping enough people. I schedule intake for 15 minutes, to identify acute needs, then refer out to the other doctors in our clinic or to in house doctors. I also red tag client files needing counseling, all aspects, that I will conduct therapy with. So far I have 90 clients, plus all the intakes I must take as head of clinical psychology.
When we have the possibility of sight seeing, we all claim to by Canadian, with accents to match. I gave Lance, Remy, and Sheri Canadian lessons. Americans are now well liked and several kidnappings have been reported on the local news. Every country I have been to seem to not care for Americans reporting they dislike P Bush, thus all Americans in general.
We have named our hotel suite Canada Central. We are greeted in a friendlier manor, so we continue to lie about our nationality.
We are picked up from the hotel lobby and herded into a suv, dark windows, and arrive at the hospital with dozens of patients already waiting.
Tonight when we return to the suite, we are having a "Canadian Party" "A". We all have to speak in kind. There will be Canadian beer and White Trash food. Should be rather fun.
A good release for the stress and hundred of files that go into the general files of the hospital.

Have to leave,
cheers,
Joe

Another Blessing


Monday 2:45 am.


" Yesterday we sat among pines and thorns Writing metaphors while birds filled the woods. Stop one brief instant while branches mourn, Hiding grief and shame among many moods, The group of us with dirty feet, torn nails, Life placed carefully beneath the roots of a tree. I remember Tuesday night because it hailed although watching through the window, I failed to go outside and gaze up with the others; the fire kept me inside, loving the flames. Later the warmth of soft and safe covers blanketed me from the day's rainy games. The day kept me in sync with my soul each time I write I am closer to whole."

The poem allows my legion of thoughts settle into the dust of the day.

We four, Remi,Lance, Sheri, any myself reside in a comfortable hotel suite, living room four bedrooms with baths, opening into the living room. We have our privacy this trip but, we spend most of out free time in the living room.

We all arrive safely to our home, our "bastion" were we can relax. Our next mission will be dinner down stairs, being yelled at, must go.
We are all blessed this day,

Love
Joe

Kenya Time Table

Well another day. my current revised Clinic Plan of Operation has been approved. The clinic is up and running by 80 per cent tomorrow. We even have air conditioning. Weather has been 50's during evening hours, and 70's in the daytime. A huge change from 110 degrees at 6 am, in Chad.

Today we have seen 87 clients with diverse needs. Psychological services, living assistance of hard supplies as well as soft supplies were rendered. Several medical referrals were made to our staff along with severe physical injury/trauma referred to ER of hospital. We also managed child care for some of the patients. (14) children from 12 to 16 years old. All is well by the hospital Supervisor stating, "Great, you did not kill anyone" interesting man. So many demands from patients and from my staff, a little green. I am sitting in on several of their sessions w/ patients, and assisted the counselor to present conclusion of a difficult conflict.
I seem to be named Doctor Joe, I hear it in every direction. I am honored. Exhausted from the day. My computer is on states time, so the time stamps are wrong. I have entered two Kenya clocks to give propective times. Here is is Wednesday, a day ahead. Time to rest.
Blessings,
Joe

Kenya Time

Our beginning in Nairobi

After arriving at Jomo Kenyatta International Airport in the southeastern region of Nairobi it felt like living in the air for days. This area is considered poorer slum areas. Remie, Lance, and Sheri all want to take a Wildlife Safari, so numbers rule, on our next free time.

Dear Max, thank you so much. My field supervisor has the report and wants to add two more elements, so it is out of my hands. My main focus lies on setting up our clinic in Women's Hospital part of Nairobi Hospital. Our hotel, Hotel Embassy is close to the Hospital, but we will continue to travel with armed rent a cops. Leave it to our resident Lesbian to find a crazy bar named Gypsy' Bar. It is said, this is probably the most popular bar in the Westlands, pulling in Kenyans, expats and prostitutes. It's as close as it gets to a gay friendly venue in Kenya. Should be a hoot.


Our first day was spent cleaning up the clinic we will be using. Word traveled fast of our arrival. Patients were even helping up clean and set up the med room, the treatment rooms, as well as the counseling suites, moving desks sittings rooms e.g. We all watch these kind, beautiful people became more comfortable with us and hopefully spread the news of the "Women's Clinic". We had time to sit at times and just be and allow the people to acquire a sense of what we are tyring to set up and our desire to help.

After a 10 hour day, we four are back at our hotel room. This being a handsome room compared to the two hundred year old hotel with rust stained showers, rats, and snakes in beds. A restaurant resides in a side lobby with interesting menus that change daily. So after showering, we are dining while we plan tomorrows activities. We all seem to feel such a wonderful sense of positive energy with this assignment.
Good night from Kenya.

MSF/Doctors without Borders/

I forgot to include the activities of MSF in Kenya. Da.

Kenya

The primary focus of MSF in Kenya is on treatment for people with HIV/ AIDS. In projects in the slums of Nairobi and in the rural areas of Busia and Homa Bay, MSF provides more than 12,000 people with anti-retroviral treatment (ART). Increasing emphasis is also being placed on an emerging and drug-resistant form of tuberculosis (TB).

Homa Bay, located in the western Nyanza province, was MSF’s first HIV/AIDS program in Kenya, opening in 1996. With an HIV prevalence of approximately 35 percent, the densely populated Victoria lakeshore is one of the worst affected areas in the country. Initially focusing on TB and on reducing HIV transmission through health facilities, free ART was first introduced in 2001.

In July 2007, 4,741 people are under care, with 3,567 of those receiving ART. With a planned merger of MSF and Kenyan Ministry of Health (MoH) activities, and the opening of three more HIV health facilities on the periphery of Homa Bay, this figure will continue to rise. MSF also provides resources and technical assistance in the piloting of a one-stop service for people with TB/HIV co-infection, including the development of the third TB culture laboratory in the country.

In Busia District, situated on the Kenyan border with Uganda, MSF runs an HIV/AIDS project in the main district hospital and nine rural health centers. In addition to the clinical services within these facilities, the project provides a system of home-based care, utilizing over 140 volunteer community health workers and running an information and education program that targets people living with HIV/AIDS and community groups. It is estimated that over 10,000 people from the district are in urgent need of treatment. The project began providing ART in July 2003 and treats 1,850 patients, 140 of them children.

In 2007 MSF is handing over three ART sites to a development partner and supporting the MoH in establishing two more in health centers, increasing the access to treatment and prevention of mother-to-child transmission in the most remote and highest HIV prevalence locations of Busia district. In Nairobi, MSF also provides comprehensive HIV/AIDS care in the Mbagathi District Hospital. In early 2005, MSF built a clinic on the hospital grounds, allowing integration of the comprehensive MSF and MoH HIV/AIDS activities. Now more than 3,314 patients receive ART, with a further 811 being followed. MSF is gradually handing over this project to the MoH.

Linked closely with Mbagathi hospital in the sprawling Kibera slum, MSF runs a project that integrates HIV/AIDS and TB into primary healthcare in three clinics. A focus of this program is the empowerment of people and communities living with the virus. Covering both Mbagathi Hospital and the slum, which has a population of over 600,000, MSF treats 4,744 people with ART and provided approximately 103,000 consultations in 2006/2007.

In Mathare, a second slum with a population of over 300,000 on the eastern outskirts of Nairobi, MSF runs a project known as the “Blue House,” located in a renovated old hotel building. The project offers free comprehensive treatment for HIV/AIDS and with a co-infection level of approximately 70 percent, MSF also treats patients with TB. In late 2006, an extension was added to the clinic to treat increasing numbers of patients with multi drug-resistant tuberculosis (MDR-TB), an emerging strain of the disease that cannot be cured with firstline TB drugs.

The number of affected people continues to rise in slum conditions that create a perfect breeding ground for the spread of the disease. Approximately 2,751 people living with HIV/ AIDS are under care and the clinic is testing approximately 300 people per month for HIV. MSF also provides many of its patients with health support in the form of key nutritional supplements.