Tuesday, September 2, 2014

surprises in Kenya: meeting Salaash

Salaash treating a Masai patient at our Shompole clinic


























One of the many wonderful things about Africa is that it is full of surprises. We received our most valuable one on our first day on our drive to Masai land. About 10 miles from the school at Endonyo-olasho, our destination, we stopped at a dispensary in Oloika. Some of my teammates knew about this small village from a stop there last year, necessitated by a flat tire. But they hadn't seen the dispensary, and they hadn't met Salaash.

For maybe the tenth time that day, our team climbed out of the van to get a sense for what kind of services this dispensary is able to offer to patients, and to meet Salaash, who would be helping us at clinic the next day. After showing us his small two-room clinic and telling us a few details of his work, we all piled back into the van. It was getting dark, and we still had to set up our tent and make and eat dinner. We knew we had a long day of clinic ahead of us.

Early the next morning our team slowly emerged from our tent, wiped down with baby wipes, put on our scrubs. We walked the 200 meters or so to the fire pit to drink coffee and eat our breakfast of bread, peanut butter and nutella. There were no patients in sight yet, just the brown horizon against the still, cloudy sky. After breakfast we walked back to the school to set up, and Shannon assured us that patients would start appearing out of nowhere. And she was right: as we pulled desks out of classrooms and hung clinic-station signs on them, children and their parents appeared in the distance, first as small red or blue dots moving closer and closer to us. We pulled a few desks from the classrooms for our first patients to sit on as they waited, and hoped the clouds would stay to keep us all cool.

As we started to see patients, I hopped around from station to station, trying to observe how clinic worked and understand how I might gather information today. At one point I saw Shannon assessing a patient. She turned to Salaash and asked, "what would you do?" It was at that moment that I began to understand that Salaash wasn't there just to interpret medical terms for patients. He was a necessary partner in caring for patients in a way that honors and understands their cultural context.

Our whole team also began to understand that our presence there was meaningful to Salaash. Because his clinical training was paid for by the Kenyan government, he was stationed by the government at the clinic in Oloika. While he seemed to receive joy and fulfillment in serving his tribe (Salaash is also Masai, though from a different area of Kenya), it was clear that he also experienced the loneliness and fatigue that come from serving in an isolated community. We were able to provide him companionship and the opportunity to learn from colleagues - a common and integral part of the Western health system, but rare in Kenya, where the provider to patient ratio is something like one doctor per 10,000 residents.

Salaash stayed with us, for a vaccination at a nearby homestead the next morning, and the whole next day, too, for another clinic in a nearby village. Some of the Masai who came to this clinic insisted they be seen by Salaash, showing us how trusted he is in his community. He is tall and extremely lean, like most Masai, and with a soft voice that might belie his intelligence and conviction. As each patient came and sat in front of him, and he asked them why they had come to clinic, Salaash leaned forward, occasionally touched them on their shoulders, held children who were sick or would be vaccinated.

By the end of the day, we were all tired. Shannon asked Salaash about skin lesions on a child's head, which she thought might indicate something fungal. Salaash looked at Shannon with a smile in his eyes and said, "No, it's just dirt. Shannon, are you tired?" They laughed together. "Are you making fun of me, Salaash?"

***
The next morning, it was time for us to drive back to Nairobi, and for Salaash to return to his clinic in Oloika. He rode in the pick-up truck with our luggage, while our team rode in the van. We drove through the village in Oloika, past men standing in front of their small shops and a child waving frantically, joyfully with both hands as if the harder he waved the more we might remember him. Our van pulled up next to the truck, then turned around and drove through the village again. And it dawned on us that we were leaving Oloika, and that we hadn't gotten to say goodbye to Salaash. We made Chris turn the van around and drive back through the village, past the men at their shops and the child waving with both hands. We piled out of the van and ran in to meet and hug Salaash, who was already seeing patients who had been waiting for him during his three-day absence.  

Salaash photo bomb

1 comment:

  1. I love this line:a child waving frantically, joyfully with both hands as if the harder he waved the more we might remember him.
    Beautifully written Betsy, can't wait for more!

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