{"id":587,"date":"2022-11-04T11:06:00","date_gmt":"2022-11-04T15:06:00","guid":{"rendered":"https:\/\/www.citadel.edu\/magazine-2022\/?p=587"},"modified":"2024-08-27T15:02:10","modified_gmt":"2024-08-27T19:02:10","slug":"the-kenya-health-care-program","status":"publish","type":"post","link":"https:\/\/www.citadel.edu\/magazine-2022\/2022\/11\/the-kenya-health-care-program\/","title":{"rendered":"The Kenya Health Care Program"},"content":{"rendered":"\n

Health and Human Performance associate professor Sarah Imam, M.D., was so inspired after a 2021 summer experience<\/a> offering free medical services in the Nairobi slums that she returned home determined to create a similar experience for her students. With the generous help of the Swain family\u2014David, \u201980, and his wife Mary, and Chris, \u201981, and his wife, Debbie, Imam put together a unique service-learning program<\/a>. In June, Imam and her daughter Mariam, along with Professor Kimbo Yee and 23 students, traveled to Kenya.<\/em><\/p>\n\n\n\n

When\nStaff Sgt. Ben Knight, an active-duty Marine Corps student, signed up for the summer\nservice-learning program in Kenya, he was not sure what to expect. But after a\nmonth assisting in a free medical clinic in the slums of Nairobi, Knight and\nhis classmates returned to the comforts of home enlightened and better prepared\nfor their future careers in the healthcare industry. It was the adventure of a\nlifetime.<\/p>\n\n\n\n

Following\nis an excerpt from Knight\u2019s travel diaries. To read the story in its entirety,\nvisit us at dev-the-citadel-magazine-sites.pantheonsite.io.<\/p>\n\n\n\n

The\nFlight <\/strong><\/p>\n\n\n\n

As\nI boarded the plane, I thought about the enormity of what we were about to do,\nand I felt like a fish out of water. On the plane, I walked past the spacious\nand clean first-class seating and settled into my row. Two seats on the left, three\nin the middle, two on the right. Stuff your carry-on under your seat and buckle\nup. <\/p>\n\n\n\n

I sat next to an African woman wearing a yellow dress, an intricate African head\nwrap and a big diamond ring. My imagination ran wild\u2014was she coming or going, how had she made her money and where was her family?  We made regular small talk and exchanged pleasantries. She had a large bag full of travel necessities and luxuries at her feet, much more fashionable than my ragtag, quickly stuffed backpack holding only my essentials, protein bars and a cell phone charger. She wore white fuzzy slippers and set her feet on the bag, which was now doubling as a footrest. She tore into the complimentary blanket and pillow and began to tuck herself in. <\/p>\n\n\n\n

She\nwas so warm and content that her comfort became contagious. My traveling anxiety melted, and I became comfortable as well. My eyelids got heavy, and I drifted in and out of sleep for the rest of the flight. <\/p>\n\n\n\n

Kenya<\/strong><\/p>\n\n\n\n

The final stretch of our travels\u2014Ghana to Kenya\u2014was a bear. I think I looked at the countdown to landing on the onboard flight tracker every two minutes. I sat in the middle row between two other passengers, like a hot dog in a bun, for six hours on Kenya Airways. We disembarked posthaste and began the dance of customs. \u201cE-visa, vaccination status and passport please\u201d was the challenge of the trip thus far. I had become a gunslinger of important documents and pulled them out like Clint Eastwood in an old western. After we satisfied the Kenyan officials, we got our baggage. Well, some of us got our baggage. A few poor souls had to live out of their carry-ons until their wayward belongings washed up. My luck was on point\u2014my baggage arrived in full. We were picked up from the airport in a large passenger van\u2014windows all around with the little curtains haphazardly slung to the sides. The seats were covered in soft, stained 1990s-style fabric. Our driver was friendly and informative. Either wear your safety belts or not, he told us. \u201cThis ain\u2019t U.S. driving over here.\u201d <\/p>\n\n\n\n

I buckled up.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

The streets were basically driving lanes with few rules. We passed numerous motor bikes carrying varying numbers of passengers. As our driver maneuvered through the throng of vehicles, we passed a couple of men carrying a cart of potatoes. When the bags holding the produce ruptured, potatoes tumbled onto the streets like tiny brown balls. Everyone passed carefully around them as the men tried to salvage what they could from the busy roundabout.<\/p>\n\n\n\n

Walls and barbed wire helped to break up property lines. There was no shortage of vegetation. Planted in the concrete pillars beneath overpasses were hundreds of little plants, part of a new beautification project created to absorb vehicle emissions. <\/p>\n\n\n\n

The Mathare Slum<\/strong><\/p>\n\n\n\n

Looking\nout of the windows of our van seemed like peeking through a veil into a kind of\npoverty before I\u2019d never seen before. The people all had curious scars, unique tales\nof hard times. Their mismatched clothes claimed no discernible brand, color\nscheme or style. Some slept on the side of the street. Some sold dirty heads of\ncabbage or corn from a makeshift grill. Some sold old T-shirts displayed like\nprizes. Many made their way through the crowded streets, chatting and bargaining.\nAnd near the road, men and women hawked their goods from wooden boards laid\nover culverts filled with sewage and garbage. <\/p>\n\n\n\n

The\nequivalent of the population of Boston lives in this three-mile area. People were\nstacked on each other like awkward Lincoln Logs. Each balcony bore clothes and\nrugs hanging over the rails. Clothes lines and structural imperfections adorned\nhigh-rise buildings. Entire floors had been blown out and left uninhabited. Curious\nfaces watched from the balconies as we drove by, and laughing children smacked\nthe balcony with both hands as they screamed out in a foreign language. <\/p>\n\n\n\n

The Pharmacy in Mathare<\/strong><\/p>\n\n\n\n

After\nthe first day, we got our bearings. An assortment of boxes of previously mixed drugs\nmeant to help the needy had now been set in place to enhance efficiency. Our\ntent clinic was split into eight rooms. Each room was just large enough to be\nfunctional. Everything was tight and, like the slums, there were no luxuries. Three\nof us started our first medical rotations in the pharmacy. Our tent box was\noutlined with small, unmatched tables to give us quick access to the 100 or so\ndrugs at our disposal\u2014drugs for pain, malaria, diabetes, hypertension and other\nailments. <\/p>\n\n\n\n

Working in the pharmacy<\/strong><\/p>\n\n\n\n

After\na few days in the camp, I started to feel a profound sense of accomplishment. Our\nteam was humble and excited to learn with every patient. After setting up the\ntables with sectioned-out areas for medications, we stocked them back as far as\nwe could and refilled as needed. We took the paper scribbled on by the doctors\nand did our best to decipher their scrawls. With the help of a local pharmacist,\nwe packaged up the medication and carefully ensured the patients understood the\ndirections. Most spoke Swahili, and while most anyone in Kenya with a basic\neducation could understand some English, this was rare in Mathare. The\npharmacist I worked closest with was originally from the Masai Mare area of\nKenya. She was direct and demanding, but a great teacher. <\/p>\n\n\n\n

Our patients were the faces of pain, cute babies strapped to their mothers with a cloth and laughing youngsters playing with stones on the dirt floor. They were old people who just wanted to talk, and shy young women, breast feeding mothers and scarred or disfigured characters. They were people with HIV, children with scabies and a man with metal instruments protruding from his calf from a surgery he couldn\u2019t afford to finish. The vast majority said \u201casante,\u201d which means \u201cthank you\u201d in Swahili.<\/p>\n\n\n\n

\"\"<\/figure>\n\n\n\n

The People<\/strong><\/p>\n\n\n\n

Just\ndays into our stay, the intelligence and sense of community surrounding us began\nto open my eyes. On the drive through to the campgrounds, I saw the resolve in\nthe shop owners as they set up what little they had to feed themselves and\ntheir families. They swept and unpacked the day\u2019s goods from a large potato\nsack. The goods were brought in on their backs and laid on a blanket or tarp for\nthe busy street traffic. Motor bikes whooshed by with various cargo and\npassengers. Vans and cars of all different shapes and sizes hurried by each\nother in a carefully choreographed dance. At the camp, I noticed a man scrubbing\nabout 30 unmatched shoes, readying them to sell later in the day. <\/p>\n\n\n\n

Mothers\ncame and sat all day in the equatorial sun to ensure their children would have this\nrare opportunity for medical attention. Children and infants clung tightly to\ntheir mothers. Their faces as they clutched the medicine and their smiles before\nthey left warmed my heart and reminded me that family ties transcend economic\nstatus. Listening to the heavy accents of the doctors and pharmacists who\ndevoted their time to help us learn was humbling. They knew every drug up and\ndown and exactly what to look for. At the end of the day, a woman was flash\nfrying some peanuts with salt and spices in a metal pot over a fire in the\ncorner of the camp. She saw people who were hungry and tired, and she shared\nher meal with us. <\/p>\n\n\n\n

Mt. Longonot <\/strong><\/p>\n\n\n\n

At\n0630 we packed ourselves into our 28-passenger limo van and headed out on our\nfirst excursion, our first weekend, and our first time venturing outside\nNairobi. We drove for two hours on a scarcely regulated highway. Vehicles of\nvarious sizes wove in and out of lanes, and on several occasions, oncoming\ntraffic screeched to a halt due to an overzealous driver. Speed bumps on the\nhighway slowed us down. After we got out of the city, we drove past a clearing\nand saw Mother Africa with new eyes. It felt as if you could see for 1,000\nmiles. Mt. Longonot, a volcano that was last active in 1860, was the highest\nmountain range in that landscape. You could make out the greenery all the way to\nit with painter\u2019s strokes of browns and reds and splashes of deep green. <\/p>\n\n\n\n

T<\/strong>he bus arrived around 0900. The day was\ngorgeous, with light cloud cover and a slight breeze. The temperature was\naround 65 degrees. Some of us rented walking sticks for about two dollars.  <\/p>\n\n\n\n

After\na briefing on the route, we broke off into smaller groups of different effort\nlevels. I was in the middle toward the back and figured I\u2019d take it all in at\nan easy pace. I wore my military boots and boot socks to protect my ankles and get\nthe best possible tread. At a clearing, I pulled out my binoculars to see zebra\nand impala grazing in a field below. We all caught up at the halfway point, and\nI was already visibly out of breath, but as we started for the top, my\ncompetitive spirit drove me toward the front. Yousef, the 12-year-old son of\nour guide and a guide in training, led the way up to the top. I was with a few\nathletes and Yousef at the front. The pace was steady, and we jogged down the valleys,\nusing the momentum to propel us up the peaks.  At the top third, there were no valleys, only\npeaks. The kind of peaks I had only seen before at various hills in Quantico\nduring Officer Candidate School. The only difference was that we were about\n2,000 meters above the highest point in Quantico. Several times I stopped when\nI didn\u2019t want to stop and gasped for air, but my pride and knowledge that a 12-year-old\nwas out there leading the way made me push harder. I made it up among the top three\nhikers. We saw the ringed summit surrounding the crater, now filled in with beautiful\ngreenery from the nutrient-rich soil of a previous lava flow eruption. <\/p>\n\n\n\n

At\nthe top, we did what any American does at a moment like this\u2014we reached for our\nphones to take pictures. The others flowed in not long after us, and we took\ngroup shots at the summit. <\/p>\n\n\n\n

I\nwas proud of us all.  <\/p>\n\n\n\n

The School in the Kibera Slum<\/strong><\/p>\n\n\n\n

A\nhand-painted sign above the door of the sheet metal building read \u201cSilver\nSprings Secondary School.\u201d Our bus was parked across the dirt road next to a\nlarge pile of trash where goats foraged for food. Inside, the students in\ntraditional Kenyan fashion sang and danced for us in an open space in the\ncompound. Some of us were pulled into the center and began to dance along with\nthem. I overcame my reluctance and joined in. My partner led the moves, and I\ncopied. My awkward foreign look and enthusiasm made everyone laugh. It warmed\nmy heart to see these young people who have endured the unimaginable smile and\ndance and laugh. <\/p>\n\n\n\n

After\nthe jamboree, we passed out supplies and donations and learned about them as\nthey learned about us. As I glanced through their notebooks, I was stunned to\nsee chemistry notes and equations that I had scarcely just learned about in my\ncollege years. These children and young teens were applying high caliber, complex\nthought while juggling life in a slum. We talked about Drake, Lil Wayne, Tupac,\n21 Savage and other artists. They were eager to know about life in the United\nStates. Dr. Imam passed out colas in glass bottles, and we toasted one another.\nThey were victims of hunger, burn, rape, abuse and other evils, enjoying a\nmoment of excitement and laughter. <\/p>\n\n\n\n

I\nwas sad to leave that day. Their determination and endurance are seared in my\nmemory. I wish we could have done more for them.<\/p>\n\n\n\n

Kibera Immersion<\/strong><\/p>\n\n\n\n

I\nwasn\u2019t so sure about this. A walk through one of the biggest slums in Africa among\nwhat I imagined would be desperate and destitute people. There were six students\nin our group, males and females, led by a woman who lived in the slum. <\/p>\n\n\n\n

We\nwalked through a labyrinth of open street markets and over broken concrete\nsidewalks. We passed a stern-looking man in his 20s with dreadlocks and another\nman sprawled out on rocks, eyes closed and chickens pecking and clucking all\naround him. A one-eyed dog got up and started barking angrily at us. Stumbling\ndown a ledge where stairs should be, we walked the final stretch. In a valley,\na small river of trash and waste assaulted our noses. In Kibera, there are no\ntaxes and no government assistance. Any water or use of a toilet comes at a\ncost. If you can\u2019t pay, you just go, and it smelled like it. <\/p>\n\n\n\n

The\nwoman guiding us grabbed her baby from a nearby neighbor as we passed a row of 10\ndoorways with cloth doors before arriving at her home. She was one of the lucky\nones. She had shelter. There were no windows. There was a small end table with\ntwo chairs and beyond that, a dresser. A sheet hanging from the ceiling\nconcealed her bed. That was her home, with its cloth door and metal roof. There\nwas no refrigerator, no electricity and no running water. We gave her maize,\nflour, sugar, soap and paper towels, and some of us gave her cash to help her pay\nrent. We wished we could do more.<\/p>\n\n\n\n

Pharmacy at Kibera<\/strong><\/p>\n\n\n\n

Our\nbus driver turned right into a hidden lot, just inches from grazing the sides\nof the narrow passage. The camp was spread out in the heart of Kibera, the\nsecond largest slum in Africa. The registration was in one place, triage\nanother and the consulting rooms in yet another area, so there was a lot of\nwalking between the units. My place of duty was the pharmacy, and the storage\nwas in a local mosque that allowed us to use the conference room, so medicine\nhad to be transported from the storage to the pharmacy. <\/p>\n\n\n\n

On\nthe horizon as we made our way to the pharmacy, we could see the skyscrapers of\ndowntown Nairobi. The day was overcast, cool with a slight breeze. A woman was hanging\nwet clothes out to dry on a clothesline with mismatched plastic clothes pins\nnot more than four feet between the walls. A bra, a half dozen tiny shirts,\ntights and a small blanket were hanging on the line. Children reached out at me,\nsaying \u201chiiiii\u201d in their best English. One grabbed my hand and tried to lick it\nas I pulled away, awkwardly laughing. <\/p>\n\n\n\n

I\ncontinued past the woman and children, past a white and brown kitten, past doors\nand people and a group of children all happy and laughing. One, a 5-year-old\ngirl in tattered high heels, shuffled around. Past the little fashionista, a\nmob of people waiting for our medical camp greeted us. <\/p>\n\n\n\n

This\nwas our second camp, and we were feeling confident. We set up the drugs and\nturned on our walkie talkies. I walked back through the maze and encountered a\nlittle girl too cute to ignore. She had on a red jumper. On her feet were blue\nand white tie-dyed Crocs. We played kick the plastic bottle. She scuttled back\nand whacked the bottle good, stumbling forward from the force. I kicked it back\nto her, and we had a good, old-fashioned kicking match for five minutes before\nI headed back to the storage room. <\/p>\n\n\n\n

The\nwalkie chirped: \u201cBen, this is Camille.\u201d<\/p>\n\n\n\n

\u201cWe\nneed a green box of Metronidazole and Diclofenac gel please.\u201d<\/p>\n\n\n\n

\u201cCopy.\nOn my way.\u201d<\/p>\n\n\n\n

The Orphaned Elephants<\/strong><\/p>\n\n\n\n

I\nput on my traditional African shirt. Red, black, yellow and blue interwoven in\nequal and intricate designs. Next, my bandanna\u2014black base with white designs\nand red roses\u2014wrapped around my head. I was dressed to meet the stars of Africa,\nthe big babies, the ivory orphans of the Sheldrick Wildlife Trust. <\/p>\n\n\n\n

We\nwalked past the gates made of vertical bamboo shoots, down a well-hidden path\nof stairs to a large opening barricaded off with a yellow rope. Beyond the rope\nwere fresh broken branches with green dewy leaves all about them, a fresh mud\nbath and a few trashcan-sized water buckets. The handlers had two wheelbarrows\nfull of two-liter baby bottles filled with milk <\/p>\n\n\n\n

Soon\nthe orphans with their trotting trunks and giant ears made their way toward us.\nThe elephants knew the routine and quickly headed for the bottle handlers. Some\nof them held the bottle with their trunks. \nThey were brown and red, almost the exact same color as the dirt, which\nmade sense with all the dirt-flinging they did with their trunks. They used the\nlittle articulation in the ends of their trunks to pinch a scoop of red dirt\nand sling it up behind and on their backs. <\/p>\n\n\n\n

After\nthe milk, they made their way to foliage. When they got close enough, we\ntouched them and posed for pictures with our hands on their hides. Their backs\nwere tough and felt almost like concrete, dusty and caked with dirt.\nOccasionally, they reached out with their trunks to investigate. The trunks\nwere softer and fleshier, with a funny little sniffer at the end. Gosh, they\nwere cute. The handler told their stories, how they were found. Each orphan had\na unique story\u2014starved parents, flash floods, violent demise, panicked abandonment.\n<\/p>\n\n\n\n

Safari on the Masai Mara<\/strong><\/p>\n\n\n\n

Our\nJurassic Park-style Land Cruiser kicked up dust as we peeled out in a convoy of\nfive vehicles. The smell of dirt, grass and the occasional waft of wild manure\nfilled the air. From our windows we saw a herd of impala in the tall grass of\nthe sprawling planes. Next on the list was the gentle giant of the Masai, the\nelephant. Pictures don\u2019t do justice to the sheer mass of these amazing animals.\nStanding in a Land Cruiser and only feet away, I could see the dirty tusks with\nwhite ivory dulled by the working dust of the giants\u2019 work. The smallest baby\nelephant I could ever imagine was being naughty, flopping his baby trunk on a\nsibling and running between his mother\u2019s front legs and trunk like a toddler trying\nto get her attention. <\/p>\n\n\n\n

Less\nthan a half mile away, we spied two sleeping lions, probably just after a meal\njudging by their sprawled-out catnap position. A cheetah looking for his next\nmeal posed for us on a large rock next to a canopy tree. As our convoy rushed\nthe scene, he fled across a ridge. We watched through the raised roofs of our\nvehicles with binoculars as the predator stalked a nearby gazelle.  His crouched position in the tall grass\nsignaled the gazelle to run for its life, and the chase ended before it began. As\nwe cruised through the bush, we passed giraffes, hyenas, warthogs, ostriches,\nrhinos, buffaloes, condors and wild birds. <\/p>\n\n\n\n

Contemplations<\/strong><\/p>\n\n\n\n

As\nI contemplated my last day and the time away from family, friends, Marines and\nmost importantly, my wife, I kept thinking back to the people we helped\u2014desperate\npeople who needed medical care. We saved several lives on this trip. We\nassisted over 5,000 destitute souls. In the slums of Africa, where food is not\nguaranteed each day, medical help is unheard of. We worked as a team, triaging,\ntreating, arranging for life-saving surgery at local hospitals and prescribing free\nmedication onsite for weeks. In the end, if we saved one person\u2019s life\u2014which we\ndid many times over\u2014we accomplished our mission and made our sacrifice worthwhile.\nAnd to the Swain family for providing this unforgettable opportunity to save so\nmany lives that changed our own lives along the way, I say asante sana. Thank\nyou very much.<\/p>\n\n\n\n

What I remember most<\/strong><\/p>\n\n\n\n

I\nremember the beauty of Kenya\u2014the landscape, the animals, the smiles on the people\u2019s\nfaces, the gratitude in the eyes of our patients and our team members. I\nremember climbing Mt. Longonot and the pictures we took at the peak. I remember\nthe grassy fields of Masai Mare elevated through rolling hills that looked like\na painting, the elephants and the other National Geographic<\/em> animals. I remember\nthe baby elephants at the orphanage, the survivors of tragedy. I remember the hospitality\nof the workers at every stop we visited. I remember the people of Mathare and\nKibera, dressed in their finest to receive free care. I remember the smiles on\ntheir faces and a certain look in the eye when a great burden had been lifted. I\nremember the words they used most often\u2014 \u201casante sana,\u201d (\u201cthank you very much\u201d)\nand \u201cjambo\u201d (\u201chello\u201d). I remember working with my team members and the good\npeople of The Citadel. I remember our weekend excursions to blow off steam and\ntake in the culture and way of life of a new and beautiful country. I remember a\nhot room in a Kenya winter\u2019s day in the tiny home of a woman and her family of\nfive whose home was smaller than the smallest room in most American houses. I remember\nthe tears in Dr. Imam\u2019s eyes when she couldn\u2019t do enough for a person who was\ngoing to die and accepted the fact that we couldn\u2019t save everyone. I remember\nDr. Yee roaming the stations and making sure we had all we needed. And most of\nall, I remember that we did save lives and we worked hard to accomplish our\ngoal of helping the people in the slums of Kenya. <\/p>\n\n\n\n

Ben Knight is currently a staff sergeant in the Marine Corps and an exercise science major. Following graduation next May, he plans to commission as a second lieutenant and continue his training at the Basic School in Quantico, Virginia.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Health and Human Performance associate professor Sarah Imam, M.D., was so inspired after a 2021 summer experience offering free medical services in the Nairobi slums that she returned home determined to create a similar experience for her students. 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