The Rhein-Valley Fitness Centre

ak. Welcome to the Rhein-Valley Fitness Centre. Here we have a full-purpose outdoor fitness complex that features a running track (two-acre lawn); a stepping machine (the road to Thugunui); a weight room; outdoor bathrooms; drinking water; fresh air; and music courtesy of the neighbouring primary school's gospel choir. Founded and built by 21-year-old Josphat Omwemga (photo), it has flourished and now has over 10 members! Josphat is an IDP that came to the hospital in January following the post-election conflicts. He now lives and works at the RVH, and is a multi-purpose employee: he cooks for the IDPs; works in the garden; and conducts general maintenance. He also occassionally moonlights as a personal trainer.

Tricky Driving in the Rain

ak. It was another busy day at the hospital. As usual, Thursday is neonatal day, which means the waiting room is spilling over with mothers and newborns by early morning. When all the neonatals had been processed, several other patients remained, so the medical staff was on the go without a significant break until early evening. By then, the rain had begun to fall, which makes it very difficult to traverse the lower part of the road leading to Kasambara. Thanks to a proper all-terrain vehicle (Land Rover), a skilled Swiss driver (Ruth Schäfer), and a charming Canadian navigator (Alex Keller), we made it down in one piece!

Collecting School Furniture

ak. It was a busy day at the hospital today. The waiting room was full by early morning and the medical staff were on the run until mid-afternoon when there was a much-needed lull in patients. Later in the afternoon, students from the neighbouring Kasambara Primary School arrived to collect their tables and chairs, donated by the Swiss organization Kids-to-Kids. It took two trips with 20 students, but within 30 minutes the furniture had disappeared, destined for good use by rural Kenyan school children.

Staff Vaccinations

ak. As Tuesdays tend to be a bit quieter at the hospital, it was decided that today the staff would receive their immunizations against Hepititis B. One would think that a hospital staff, especially its medical staff, would be immune to the fear of needles. However, Nurse Kennedy, who some days immunizes hundreds of patients himself, could barely contain a shriek as the needle was inserted. He was not alone in fear...several of the staff grimaced in 'severe pain' when receiving their injections!

A routine trip to Thugunui

ak. After a hectic morning at the hospital, we made a routine trip to Thugunui, approximately 30 minutes by car up the mountain, to check up on the water station. Thugunui's water station was completed last year at this time, a joint venture between the RVH and Austrian NGO Schilling for Schilling. As always, the villagers welcomed us with open arms and the school children flocked to my flashing camera for a chance to see a photo of themselves. Inhabited by over 30,000 people spread across a distance of 25km, the greater region of Thugunui is nestled into a quaint valley atop a mountain range bordering the Rift Valley and Central provinces of Kenya. Isolated from electricity or running water, it has an old-fashioned, nostalgic charm about it, especially when compared to the hustle and bustle of Nakuru.

Click on the photos to watch them in larger size!

Sticks & Stones

ak. On our way to the hospital this morning, we came across a large group of women gathering and carrying wood. According to Ruth Schäfer, many of these women are IDPs (internally displaced persons) who sometimes walk several kilometers just to find wood, which they use for heating and cooking. In this case, the land on which we saw these women gathering wood was private, so not only did they endure physical hardship, they also risked imprisonment if caught. In Kenya, due to mass deforestation, cutting down trees or using wood for personal purposes without a license is illegal and can result in severe fines or long terms of imprisonment. Another unfortunate example of Kenya's IDP plight.

The Miracle of Birth

ak. A beautiful baby boy was born today at the RVH. While the rest of the hospital lazily sauntered through a quiet Saturday, inside the small maternity ward, a young mother was in painful labour for over three hours. When the baby finally released itself from the womb, it had inhaled placental fluids into its lungs and was unable to breath. The medical staff had to act quickly and resuscitate the boy who had already fallen into unconsciousness. Within 15 minutes though, the fluids had been expelled, airways cleared, and the boy was already proving he would be the next member of the Lake Nakuru Gospel Choir. Another successful day at the Rhein-Valley Hospital.

Moving Home

ak. Today we received another stark reminder that the struggle of Kenya's internally displaced people is ongoing. This photo portrays a typical sight of an "IDP family" moving home. As IDP camps gradually close and donor support drys up, people are forced to return to former homes where potential tribal hostilities remain. Although government officials have made attempts to completely close IDP camps, there remains tens of thousands of people who cannot return home, be it for lack of safety, lack of funds, or a combination of both. Bear in mind that many of these people experienced unspeakable horrors during last year's conflict, and returning home may also be undesirable due to the possible re-emergence of painful memories.

Neonatal Day

ak. Thursdays at the RVH are neonatal days. Mothers and new-borns clog the waiting room and spill onto the lawn outside. Each mother-infant duo waits patiently so that the baby can be weighed and measured to monitor for possible malnutrition. Babies are also given vaccinations if needed, for which the hospital follows a standard international protocol. In Kasambara, where computers are about as common as Polar Bears, following this protocol requires careful manual record-keeping, otherwise children could be over or under-inoculated. By day's end, over 50 mother-infant duos had been seen and most will be back again next Thursday...same place, same time.

Celebrating Mama Matata

ak. This morning, a group of over 30 women from Kasambara congregated at the hospital to express their thanks for the support they have received from the hospital and its director, Ruth Schäfer. Following recent misunderstandings with the local church and secondary school, the womens group wanted to ensure Ruth and the hospital's staff were aware of the community's appreciation for the hospital. As mentioned in previous blog entries, the Rhein-Valley Hospital services over 80,000 people from the Kasambara and Thugunui region, a rural area 45 minutes outside of Nakuru.

An Abundance of Vaccinations

ak. Today was a busy day for vaccinations. The hospital generally has specified vaccination days each month, but sometimes patients present even when it is not a vaccination day, as several did today! Most were between the ages of 5 and 12, with some older and some younger. The most common vaccinations are those that protect children against cholera and hepatitis, diseases that were common in the Kasambara-Thugunui area until the hospital began offering its services in 2004.

Two Burn Victims...

ak. It was a busy Monday at the Rhein-Valley Hospital. By 9:00am, the waiting room was already full and over 15 patients were waiting outside. Within one hour of each other, two completely independent pediatric burn victims arrived for emergency care. One had fallen into a fire and burned her knees. The other had tripped, while walking backwards, into a pot of boiling water. Nurse Kennedy worked diligently and efficiently, and within 45 minutes the boy was on his mother's back heading home...mind you, without a smile.

Quiet Day at Lake Bogoria

ak. Sundays are quiet in Kenya as most people go to church and don't work, so we made a quick day trip to Lake Bogoria National Reserve. Approximately 2.5 hours north of Nakuru is this non-fenced reserve, which is know for its famous geyzers. It is also host to a variety of wildlife, including flamingoes, ostriches, impalas, wart-hogs, hyenas and a herd of elephants that migrate over the park's surrounding mountains two or three times per year. En route, we also had several encounters with the indigenous Pokot and Tugen residents of the area, many of which still reside in traditional Kenyan huts. (Click on the picture to see it in large format)

Washing children and clothes...

No big news for tday. Many refugees were washing either their children or their clothes. I checked the camp as usual from time to time and everything seems to be in order. - Mama Matata

Click on these two pictures to see them in larger size on our photoblog Kenya Photos

Unnecessary misunderstandings

ak. In March of this year, in order to release from customs the recently received container of school supplies donated by the Swiss organization Kids to Kids, the Rhein-Valley Hospital recruited the help of four local elementary schools. The headmaster of each was asked to write a letter to the Minister of Education with the promise that each of the four schools would receive a portion of the supplies from the container. A portion was also to be donated to the Tegla Loroupe Foundation and on Wednesday, the representative from the Tegla Loroupe Foundation collected their portion. The headmaster of the neighbouring secondary school misconstrued this pick up, thinking that the supplies were being given away and that the four schools who had written letters to the Minister of Education would not receive theirs.

As a result, upon arriving at the hospital this morning, Ruth Schaefer received a letter from the headmaster, which accused the Rhein-Valley Hospital of having used the schools’ names to release the container and then distributing the supplies to another recipient. The headmaster had also copied several high ranking government officials in the distribution of the letter. Since these matters are highly sensitive in Kenya, we immediately rushed to the offices of the Nakuru District Minister of Education to clear the hospital’s name. Luckily, the situation was resolved by day’s end, but the headmaster was highly reprimanded for his letter. Such correspondence can easily cost an NGO its license in Kenya due to corruption amongst many others. A close call, but the Rhein-Valley Hospital survives another day! Such is daily life for Mama Matata (Ruth Schaefer), translated: she who solves problems.

The truck for the Tegla Loroupe Foundation is loaded

Wandering through the garden

ak. It was a quieter thursday at the Rhein-Valley Hospital, so Ruth showed me the hospital's vegetable garden. Under the guidance of Dr. Wanjara, the garden has flourished and now yields a wide variety of vegetables including spinach, Irish potatoes, carrots, cabbage, broccoli, celery and cucumber. The food grown in the garden is used to feed the hospital's patients and IDPs. Wanjara also uses specific vegetables in the treatment of HIV/AIDS, diabetes and hypertension patients. The garden is currently undergoing an expansion which should be complete by December. When finished, it will contain over 20 types of vegetables.

Malaria and pneumonia cases

ak. It was a busy day today. Amongst several cases of malaria and pneumonia, two elderly patients presented with severe asthma attacks. When they arrived at the hospital, they could barely breathe. Both had walked for over an hour so they could receive care. In Kenya, people walk or ride their bicycle to receive care for conditions that would otherwise be considered severe in the Western world. Both patients were treated with steroids, hydrocortisone, antibiotics, and within one hour they were on their way home again, a smile on their face..

The "short rain" season has started

ak. The "short rain" season has started in Kenya, which signifies the start of spring. During this time, it rains nearly every day, but in short spurts. Earlier in the year is the "long rain" season when it can rain for days at a time without stopping. Today it rained more than usual for a typical "short rain" day, so we were unable to traverse the road leading to the hospital. Instead, we ran errands in Nakuru and made a quick stop at Lake Nakuru National Park. Unfortunately, safari tourism in the national parks has not recovered since last year's riots, which has a significant impact on Kenya's economy. On the other hand though, I'm sure the animals don't mind the diminshed traffic.

Observing the hospital life in Kasambara

With a staff of 20, which includes a mere five medical personnel (one doctor and four nurses), the Rhein-Valley Hospital is nothing short of a miracle for the people it services in the Kasambara area. Today, Dr. Wanjara gave me my first tour of the facilities. It has treated over 80,000 cases and has serviced over 8,200 new patients this year alone, not to mention the 500 internally displaced persons that inhabited the property for the past eight months. On an average day the staff will attend to 45 patients, many of which are malaria cases. With 12 beds for in-patients, one observation room, one small operating theatre and one small maternity room dedicated to child birth, one would think practicing medicine with such little resources is impossible. Apparently it is not.

I am from Ottawa, Canada and am happy to be here at the Rhein-Valley Hospital in Kasambara. A recent graduate of Health Sciences and an aspiring doctor, Ruth Schaefer has granted me the opportunity to observe the medical staff at the Rhein-Valley Hospital. I look forward to learning more about rural medicine and about the colourful Kenyan culture. I will also be maintaining this blog until December, through which I hope to share with you my experiences and observations. -Alex Keller

Touring Nakuru

ak. Today we did a brief tour through the highlands of Nakuru where the wealthy locals live in their villas and send their children to the many local private schools. However, in stark contrast, within this same area is the town's IDP (internally displaced persons) camp, which houses over 14,000 people. Here we stopped to take some pictures with the children. It was moving to see that children who have so little can still smile so brightly! Photo: Alex Keller