Day Eight

We began our day at the Kenyatta University health clinic, which serves students, faculty (i.e., lecturers), and staff. We met a surgical specialist, Patrick Mwangi, MD. He asked about our journey so far, and discussed what he does at the clinic, as well as his ongoing PhD research on severe skin lesions and degloving (a severe injury when skin is ripped off bone that requires skin grafts among other care). He posed some questions to get us thinking that involved different treatments for stage III and IV cancers and explained that typically there isn’t much they can medically do for patients once cancers have metastasized, though in some cases they might be able to treat with chemotherapy or radiation. He showed a few brave souls (Dr. B, Riley, and Charlie) various treatments for severe wound care, and explained that most of the injuries that he treats are caused by vehicular accidents. As we have been driving around, it's become clear that driving in Kenya is more dangerous than in the USA. Seatbelts are not always used, roads don't always have dividing lines, people and animals cross busy highways at slow speeds, and cars are often bumper-to-bumper.

Once Dr. Keraka joined us, we trekked to Ghana Street, another part of KU’s campus with various smaller offices and clinics, and went to the reproductive health center and HIV/AIDS care center. The center was created only within the last 20 years in order to fill a need the main clinic could not offer. We met with Dr. Karuri who specializes in the treatment of HIV/AIDS and who founded the center as an important step in HIV/AIDS care and destigmatization in Kenya. He explained both the sociocultural aspects of the disease and the courses of treatment. According to him, HIV/AIDS is a highly stigmatized disease and even healthcare professionals can develop bias or perpetuate stigma against HIV-positive patients. For example, healthcare staff may be hesitant to touch a patient with HIV; the individual's community may ostracize them; and even staffing the clinic is difficult due to the assumption that if you go to this clinic even for work, you must be HIV positive. Dr. Kururi said, and we agree, “When stigma is in action, that is discrimination.” 

As healthcare professionals are supposed to be unbiased in their treatments, the stigma around HIV/AIDS causes discrimination against those patients. This stigma comes from lack of knowledge and awareness about HIV/AIDS and now it is transmitted. Dr. Kururi explained that it is unlikely for medical students to learn about the virus and societal norms cause HIV/AIDS to be a misrepresented and feared illness, which goes unreported and untreated. This causes Dr. Kururi to be the only one of two doctors at the center to treat the illness, yet those patients deserve to be treated with care and respect. Drs. Jalloh and Breitwieser suggested taking on medical and pharmacy students from the university that may be interested in the treatment of the virus to recruit and train them before stigma sets in. 

After Dr. Kururi was done explaining what he does at the clinic, Isaac, another healthcare professional on Ghana Street, discussed his screening, treatment, and tracking of patients with tuberculosis (TB). Tuberculosis is a deadly respiratory disease that is highly contagious. There were 12,300 cases in Nairobi alone in 2023 (not including cases that went unreported). Isaac helps to facilitate a nationwide initiative that combats TB by performing contact tracing, supporting community health workers, and maintaining patient support groups.

After the meetings in the morning, we arrived at BSSC for lunch. We noted that all the televisions seemed to have the news running, so we had an in-depth discussion about Kenyan politics. The highlight of this discussion was post-election violence, and the power and impact of the Kenyan Supreme Court Chief Justice, who happens to be a woman to curtail violence through her rulings. The people respect her, which shocked us, because the citizens of the United States often show brazen disrespect of women, especially women in power. We finished our meal before returning to the conference center, where some of us took naps and rested for the remainder of the day.

And here we ago again... another blackout. The lights flickered a bit, turned off but came on again, but the generator failed. We found out later that a tree fell on a powerline (we've been experiencing stormy weather), so we all went to sleep early in the dark with no WiFi or electricity to recharge our phones.

By Izabelle & Charlie