Thursday, December 17, 2009

Impunity and the Siamese twins

The headlines of the Daily Nation today read:
"How corrupt officials stole free primary school cash"

Several senior officers at the Ministry of Education were suspended for misappropriating 37 million shillings (370,000 euro). The money was donated by DFID (UK international Devleopment fund) for free primary education for 100, 00o children. The report states that payments were effected through 44 payment vouchers, involving 29 senior officials. The funds were embezzled through fraudulent accounting used supposedly in workshops and training. DFID has since withheld 1.2 billion for Free Primary Education untill audit queries are addressed, culprits charged and cash recovered.

Donors are pulling out due to the corruption. Thousands of innocent children will be affected and may not be able to go to school next year because of greedy officials who were employed to act in their best interests.


This is what it means in Kenya: embezzlement, corruption, lying, stealing, and openly to as if people are not accountable for breaking the law if they caught

Today, I received a referral from an OT about Siamese twins joined at the stomach, sharing a liver and other vital organs. Their parents have abandoned them, leaving them at Kenyatta National Hospital, to be cared for by the nursing team, who do their best to look after them.

Their abandonment has caused a few issues.

Firstly, the parents have not signed consent for surgery so the twins may face many years of being bedridden, rather than having an actual chance at living

Secondly, due to the lack of stimulation, the children haven't learned to speak yet.

They are 1 year 3 months and are spoken to in several different languages depending on which nurse attends to them: Kikuya, Kiswahili, and English by their Irish Speech & Language Therapist; Somali, their mother tongue by their parents who occasionally come to visit.

I met them today for the first time. They are learning to stand with the help of the dedicated Occupational Therapist. They reached for me today and one of them actually pulled a rib of my hair out from the root...painful!!

They have been abandoned because the parents live far away on the coast and don't know what to do with them. Disability is a major stigma here and brings shame on the family. I'm guessing this is part of the problem but I can't be sure as I haven't met the family. There is also the risk that one of them may die as they share vital organs. The parents may fear they will loose one or both of them.

Nevertheless, the father has given up hope and isn't involved in their care

Doctors have consulted a surgeon in China who has performed a similar surgery with success.

We are waiting to hear. Its in the hands of the therapists now to improve their quality of life

So I'm on the management team.My first case of Siamese twins with language delay
I am looking forward to seeing them again in Jan. Today, I just did a brief consultation with advice for the nursing team.

Apart from work, I'm heading to Zanzibar to begin my Christmas holidays. Not that you would know Christmas is coming. All the annoying stuff is omitted. No Christmas carols, or crazy shoppers or christmas parties. Just people awaiting time off work to be spent with their family upcountry.

No gifts or special food. Just another day off with no fuss

Thats the way I like it. This year, no fuss. Rather, sunshine, swimming, spice tours, going out to new places on a tropical island, snorkeling, not worrying about what I wear.

Flip flops and a syrong, vest top too. No makeup

Simple and easy and fun. Zero stress

Can't wait

Happy Christmas to all at home

I'll text on Christams day

Tuesday, December 8, 2009

The hospital, new apartment and Christmas plans

So I have finally moved out of the Mbagathi way apartment.. away from the constant noise of traffic and over to the peaceful grounds of Kingara Road, near Lavington. What a culture shock the move has been. I feel as though I have left Africa momentarily..

There is a pool downstairs which no one uses as the water is too cold; the house woman cleans the house twice per week and there is a TV, not that Kenyan TV is that spectacular but at least I can watch Brothers & Sisters and other gems like North & South (upper class woman from London in 19th century moved to Milton and falls for industrialist- new money so she has to compromise...all that English reserve, the slow burning romance is developing nicely..its wonderful.

Anyway besides watching DVDs, I have been very busy at the hospital. My colleague lost his father in law and as man of the house, he is expected to look after everybody else so he has taken indefinite leave, which means that instead of showing up late at 11 am for work, he doesn't come in at all. I have inherited his caseload. My door is always open. As one client walks out, another one walks in.

Sometimes, I need a translator as parents communicate only in Kiswahili. When this happens, I shout outside my door, "ANYONE HERE SPEAK ENGLISH? GREAT FOLLOW ME AND TRANSLATE FOR ME PLEASE."
and then some poor sod from the waiting room, who popped in for a hearing test, is conducting a speech and language assessment in English and Kiswahili! So much for confidentiality!

Speaking of confidentiality, there is none. People walk in and out of my room as if its their living room; to chat, wash their hands or tell me all the intimate details of the next client's medical history, in the middle of my session.

People are not big on privacy either. People stare in the window to see what I'm up to. I am slowly getting used to this but it takes a lot of patience and cultural sensitivity.

And then there is the constant searching for the file. When a client comes to see me, they pay a fee of 500 shillings to open a file. Sounds straightforward but not in K. Hospital. This process can take anything from 10 minutes to 30 minutes. Meanwhile, I'm sitting in front of the client wondering whyon earth they were referred to me as it may not be immediately obvious.

I have become a lecturer to 4 foreign audiology students..bright 20 somethings from Nigeria, Uganda, and Kenya. They seem so focused, motivated and eager to learn, unlike many students I know (I myself only focused in 4th year, dossing my way through 3 years of lectures and practicals)

So, I'm having a christmas party next weekend. Just a few mojitos and beers before heading out next Friday night. If its nice, it might even turn into a pool party (always wanted one of them).

Preparations for Christmas are beginning. Rather than shopping for a list of people, I have booked a cottage in Tiwi beach for New Years, bought a "forthy thieves" New Years Eve party ticket, a bus ticket to Dar Es Salaam and a room in Kendwa Rocks, Zanzibar...nice change from Sullivans in Gort

10 other volunteers are also coming so it should be a nice crowd. Looking forward to 3 weeks of beach time! Well thats all the news from Nairobi.

Goodbye and Goodluck