Kenya Community Participation: By Sylvie Pereira, Portuguese Nurse.

If you feel like actively giving in the health area is something that you want to experience, Kirwara Hospital is a great option! You have so much to learn and to teach … the sharing of knowledge is constant!

Giving is a way of life, it’s in our way of being. There is nothing better than being able to help a community in the first place, helping to improve their day. How good it is to be useful and to be citizens of the world attentive to the needs of others!

I was in Kenya, more specifically in Gatanga Village, for two weeks in November, 2018. Kirwara Sub-District Hospital was the place I chose to provide health care as a nurse.

Our house is right next to the Hospital, so after a typical Kenyan breakfast, always prepared with a lot of love and care by our Martha, I would leave there in a loaded uniform and backpack, ready for another day’s work. Along the way there were many smiles, nods and wishes for a “good morning!”. So the children stayed so excited when I was passing on the street!

Arriving at the Hospital, it was time to greet the health professionals who were already there.
Now, I was really prepared to begin my daily journey at about 8am.

Patients waited to be called outside of the Outpatient room. The needs of non-urgent patients were the realization of a dressing; administration of medication, essentially intravenously or intramuscularly; performing sutures or removing them; such as the administration of insulin; administration of treatment to patients with tuberculosis and their daily follow-up; removal of foreign bodies; etc.
However, emergency cases also arose and we had to be prepared to act and prioritize care! Cases such as altered state of consciousness due to severe hypoglycemia, heart failure decompensated by an arrhythmia, exacerbation of chronic obstructive pulmonary disease, asthma attack with severe respiratory insufficiency, motor vehicle accident injuries, burns, work accidents, anaphylactic reaction , among many others …

Here the reality is quite different from the one you and I may be accustomed to, so we should not want to change everything, because people, resources, the national health system, culture, living conditions … are different! It’s we who have to adapt to difference, accept and respect! Of course, we can give our opinion (which is always very respected) and discuss the differences in care.
I learned that we have to do the best with what little we have! That was the motto of my work weeks.

The shifts were always very laborious, but so rewarding! Language was not a problem, for when users didn’t understand or speak English, sign language, touch, demonstrated willingness, and tolerance were put into practice. When there was no understanding, soon came the local Nurse, or some other professional, or even another patient did the translations.
You never feel alone, there’s always a lot of help between all of them!

In the middle of the morning, if the shift allowed, we would go to the tea room for a break. The Kenyan tea and coffee are so good! The health professionals exchanged impressions and we spent a good time together.

Then we would go on for some more until lunchtime, around 12:30 pm. Moment, when I would go home and meet with the coordinators of the project. We had lunch, where I spent great time talking about my morning adventures.

About 2:00 pm, it was time to get back to work. When we could, we would recover the material from the room, we would deal with the disinfection of the materials and we would guarantee that the cleaning of the place was carried out, as well as the garbage removed to proper place.

Throughout the shifts, there were many impressions exchanged about health differences between Kenya and Portugal, my country. It’s good to know other cultures and, even more, to know how health works in other countries. Better yet, live those differences!

At 5:00 pm, I would return home and go upstairs to the apartment, I could smell the cooking of our specialist! Before I tasted them, there was still time to relax, while drinking tea and talking about the day with the coordinators. There were so many doubts and curiosities!

This project allows the visiting health professional to actively participate in the sharing of information to provide health care in a wide range of areas, such as Inpatient care for pregnant women, parturients and newborns, to children (more important areas, relative to the birth rate); to HIV and Tuberculosis users (more frequent diseases); operating room (of simpler issues, due to the level of care of this Hospital – level 3, there are 6 levels); in the Emergency Room or Outpatients Room, where direct support is given to doctors and patients who arrive from abroad.
Deep down, we know that we can’t do a lot! We just want to!

The experience was very rich in learning, very gratifying to see my work recognized by colleagues and patients, because no amount of money can be paid for this sense of mission accomplished!
I was very well received and accompanied throughout this entire journey.

There was still time to walk around, go to the market, visit the fountains, visit a coffee factory, take a trip in a matatu (typical taxi) and go on a safari in Masai Mara. There is time for everything, just speed it up!

I want to go back and live all this again!

The Kenyan people are very welcoming and teach us to see and live life in another way, where the philosophy of Hakuna Matata is part of their daily life.

Thank you so much for all this life experience, personal and professional, that made me a much richer person!

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