A depressing day

It all started well enough. Peter Wanyoike, one of the neurosurgeons in Nairobi, offered to take me with him to the regional hospital in Nyeri where he does voluntary outreach once a month.

We arrive after a two hour drive and immediately settle into our "clinic". A very small room with Peter and I sitting across a desk from a local G.P. who is presenting cases to us in rapid fire fashion (one patient is still putting on their coat as the second famiily is seated -- all in a less than 80 sq foot area.

Only five or so adults with everything from headache to a ruptured cervical disk. The latter is misdiagnosed by Peter (I believe) after a brief examination. I then examine him and offer what I think is the correct diagnosis. Then at least 10 children with meningoceles, encephaloceles, malfunctioning shunts for hydrocephalus, untreated hydrocephalus and two pediatric brain tumors. Very sad in terms of incomplete treatment, dellayed diagnosis, etc. Most will be treated after MRI's, etc. in one month when Peter returns.

We then make rounds in the superheated newborn nursery on a newborn with a meningomyelocele (google it if interested). Finally off to a private hospital to see a patient Peter operated one month ago who presented with abrupt onset of paraplegia. She turned out to have Pott's disease (TB) of the spine and remains paralyzed though with a flicker of function suggesting at least some possibility that she may walk.

I then had a hospital lunch of typical kikuyu food (picture below if it works). Actually quite good and I did not get sick.

The greenish stuff is a mixture of potatoes, palm leaves, banana, beans and corn and is actually very tasty

After extensive shmoozing with doctors, nurses, etc. we then return to the regional center to do three operations starting at 4:00 pm. Actually residents did all the surgery and Peter and I supervised and helped them along.

Well after dark we checked into Treetops, a place that Queen Elizabeth I visited after death of her husband. Not much done to the physical plant since then (at least 50 years ago), but the food was suberb and thank goodness there was a working fireplace in the room as it was quite cold.

Report for Saturday, January 17