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June 2013
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2013 Kambui

The day started early, many of us up around 5 am, so that we would have time to pick up the University of Nairobi nursing students before heading to the two separate clinics of the day in Kambui and Kigumo. Since Nairobi traffic is always unpredictable and usually horrendous, we made our best efforts to eat breakfast, grab our bags and be on the bus by 6 a.m. Since we were dividing into two clinic groups with the Kijabe students from last Saturday in one group and the Nairobi students in the other, when we arrived at the U. of Nairobi campus half the team introduced the other half to their partners before we quickly loaded back onto the bus and began reviewing the protocol so that when we arrived at clinic 5 in Kambui we would be ready to get started right away. We struggled to hear each other on the noisy bus, and had were packed close enough together that it was hard to have enough space to show and explain to our partners the various handouts and forms we would be using during the day. But our partners caught on quickly, or were quickly refreshed if returning from last year, and we were all ready and in good spirits when we arrived for what we knew was likely to be a busy day.

After the other half of the team drove off to Kigumo where they would meet up with the Kijabe students for clinic 4, we went inside the clinic building to determine a layout and get set up as quickly as possible, especially in the registration and anthropometrics areas. Off of a main hall the clinicians set up in three small rooms towards the far end, while the screening stations were set up in the first 3 or 4 and the registration station was just outside in an entrance foyer. Surface area was sparse in this clinic, so we did our best to find tables and desks to be used for screening and treatment. Some of us were able to dust off and use a narrow bench we found for both seating and table space, while others were able to find and share tables, and still others were set up in only chairs or ended up standing or rotating around while doing patient measurements. Ready or not, before long the patients started making it through registration and the anthropometric (body measurement) stations and coming to our somewhat organized screening stations.

We were fortunate to all start the day with two Nairobi nursing students to work with instead of just one, and worked on the go to both see patients and screen accurately while also trying to find the most efficient system with and extra pair of helping hands and additional interpretation ability. At some stations the groups of three were able to work fluidly to take detailed histories, ask questions about lifestyle and diet, and take the all important measurements of blood pressure and blood glucose. Others found working with pairs of students to one patient to be more efficient, which enabled a group of Nairobi nursing students to sit with patients just outside the screening rooms to interpret and take a lot of information for the forms before they reached our screening stations, saving the screeners a lot of time with each patient. Students from Nairobi and Peer Mentors were also able to rotate among the groups of waiting patients and take preliminary blood pressure and glucose measurements, and also cover screeners for much needed 10 minute tea breaks.

At my station I was partnered with David, a student who could speak Kikuyu, the most prevalent tribe and most common language amongst our patients. Since many of our partners from Nairobi spoke only Swahili, David spent a lot of time moving between stations to help interpret for patients that only understood Kikuyu. Whenever he had to move to another station, however, there was always another Nairobi student ready to sit down and help at my station. In the whole day there was just one instance where I was able to communicate with my patient on my own as they spoke great English, but it was nice even the once to be able to do all of the questioning and health teaching. At some point in the day many of us at the clinic were visited by a gregarious (and mischievous) toddler with an attraction to medical equipment. I was reminded quickly of the dangers of handing a two year old your watch to play with when you were going to need it in less than 5 minutes. But she was a welcome visitor at our screening station, and provided a lot of smiles as we got through the dragging middle of the day.

As the day progressed I know many of us were working with challenges such as short supply of certain supplies, close quarters and limited surfaces to work on, little time to sit, our partners being needed in more than one place, and so many patients to see before dark approached. But overall felt that the day went smoothly, I think we met those challenges and got through the day on a positive note. We were able to see around 130 patients at Kambui, and the clinicians were then able to quickly pack up and go to assist a few miles away at the Kigumo clinic. Considering we were not originally planning for two clinics in one day the team, clinicians and peer mentors especially, did a great job of making a well oiled machine out of what could have been a very difficult and hectic day. Having the group of students filling out the back-of-the-card questions with the patients and having some of the measurements done before screening and health teaching made a big difference in our end of the clinic.

Our success and hard work were rewarded with a generous and delicious lunch (with plenty of chapatti) from those in charge of the Kambui clinic, and those of us who were not asked to go and help at clinic 4 were able to spend quality time talking with the Nairobi students and sharing stories about the day. After a few hours the bus returned filled with the weary Kigumo team, and we loaded in the rest of the group and supplies for a long ride back to Nairobi, with the pleasant thoughts that our double clinic day was now successfully behind us, and that the next day we would be able to rest and recuperate at the guest house.