Dr Saud Jukaku visited Kenya in November 2016. Here are some of his reflections:
Ever since medical school, I have had the desire to visit Africa, in addition to doing some medical relief work. A few months ago, I got an opportunity to go to Kenya with Doctors Worldwide.
As a GP, I was in a good position to have a look at the primary care facilities that had been set up in Kenya and provide Doctors Worldwide UK with some feedback about how they were running.
The advantage of going through Doctors Worldwide was that I could go on a two-week trip rather than something longer that larger medical charities would often ask for. It was also easier to tailor the trip so that both the charity’s needs and my needs were met, in terms of objectives and itinerary.
When I told my friends I was going to Kenya, some thought I was going on holiday, possibly on safari. However, rather than seeing the Big Five, I was more worried about avoiding the Bad Three – malaria, diarrhoea and vomiting! So I armed myself with a course of anti-malarials, cipro and metronidazole to prepare myself for the adventure!
I flew into Nairobi and was met by Anna, the Doctors Worldwide Kenya manager. We flew into Kisumu in the west of the country, on a small plane. Thankfully I had flown in small planes before and so wasn’t too mortified when I saw it.
After stopping overnight at a small hotel, we continued our journey by car to our destination which was an hour or so away. Muhuru bay is a small town on the shores of Lake Victoria. It is a very poor town, which relies on fishing and not much else. Unfortunately malaria and HIV are endemic and the HIV prevalence is said to be at 30%.
As someone who has lived in the Indian subcontinent, I thought I had seen poverty. However, not only was Muhuru Bay much more poverty stricken than anywhere I had ever visited before, it’s a completely different kettle of fish when you have to experience it first hand. My accommodation, very kindly given to me for free by a local family, was clean and cosy, but there was no running water, no electricity and just an outside toilet.
Anna, who was very hospitable throughout the trip, didn’t fill me with much comfort when she said there were occasional scorpions and the odd snake in the local area. I got even more worried when she calmly told me that she had contracted malaria twice. Thankfully I managed to avoid any tete-a-tetes with any venomous animals whilst out there and anti-malarials dealt with the mozzy risk. The local people were very friendly but I was confused when I found that all the local kids were laughing at me and calling me ‘Mazungo’ as I walked past. When someone told me this meant ‘white man’ in Swahili, I chuckled to myself as I looked at my brown skin and thought ‘I never experienced this in the UK before!’
It is said that you really get to know the character of a man when you travel with him because he is out of his comfort zone. The local food was not to my liking and so I followed my own version of one of Newton’s Laws – what goes up must come down. I could call it Jukaku’s Law – what goes in must come out. And so I decided to cut down my food and water intake so much that I hardly went to the toilet for a whole week. In fact, I rationed and enjoyed my John West Pasta ready meals so much so that I felt like I was eating from a Michelin star restaurant.
I found that the clinic was doing a wonderful job serving the local community. I was pleasantly surprised at the professionalism and dedication of the staff at the clinic. The clinic was open 24/7 and had 24 hour electricity through the use of solar panels, although the equipment was quite basic. Treatment and medication were given to the local populace at below cost (patient fees are standard even in public facilities). Most of the patient contacts were out patient consultations for malaria and other infectious diseases but there were also chronic disease cases, immunisations and a fully functioning labour ward for normal deliveries. I learnt the phrase ‘low cost – high impact’ and saw the clinic as a perfect example of this.
One particular patient still sticks in my mind. She came in looking quite unwell but said she did not have enough money to pay the nominal fee. Unfortunately, some of the local people had been taking advantage of the charity’s generosity and had been failing to pay their contribution even when they had the means to. As this patient looked unwell, they decided to treat her. It transpired that she had malaria as well as being a newly diagnosed case of HIV.
After about five days in Muhuru Bay, I would be lying if I said I was not looking forward to leaving for Malindi, a small coastal town on the east coast. My stomach was telling me that it couldn’t take much more pasta. Hot showers were becoming a distant memory as bucket washes took over. We flew from Kisumu to Malindi and stayed in a nice little hotel on the beach. The clinic here was similar to the one in Muhuru Bay but was only open during the day and did not have a labour ward. Next door was a children’s school which received free healthcare from the clinic and I had some fun with the kids as can be seen in the picture below.
I thoroughly enjoyed my trip despite finding some of the aspects challenging. I realised that we live in luxury in the UK even when we don’t think we do. It really opens your eyes to what life is really like for many millions of people in the world and makes you thankful for having running water or a light at a flick of a switch. Rather than doing much for the people out there, I gained much more benefit for myself. Seeing poverty like that makes you more thankful and content for the luxuries and opportunities that I have in my own life. I would definitely advise other doctors to go, even If it is for 10 days because I believe the experience should improve you as a person. In addition, you can see a beautiful part of the world and contribute to helping the lives of others at the same time! I would call that a good entry in your appraisal portfolio!