Family Medicine and Cheetahs

Our trip to Webuye was a success. Our main goal was to learn from those that started family medicine in Kenya, in order to find out what was needed to start their program, to see if another family med program in Kenya makes sense, and what the graduates were doing with these additional years of training under their belts. The overall answer is, it's not clear. And this was surprising. I had expected that training family medicine doctors in Africa was a slam-dunk deal. Of course a physician that is well-trained to handle the majority of things that come through the door at their district or community hospital is a good thing, especially if they are also trained in assessing the needs of their community through basic research and can help manage a hospital. But the reality in Kenya hasn't been so clear. I think overall, family medicine in Kenya makes sense, but the definition is still evolving. It will be interesting to be here at the relative beginning.

From Webuye we took 4 hours of public transportation to Kisumu, our other home city on Lake Victory. We met with medical school faculty at New Nyanza Hospital, the big, five-hundred bed provincial hospital known locally as "Russian", as it was built by the...wait for it...Russians, back in the 1970s. The facility doesn't look like it's had much work done to it since then, but there were some cool features. They have a 5 bed ICU, though they only have oxygen piping for 3 beds, and I'm not entirely sure that they had a working ventilator. They had a big room for adult hemodialysis, though only two machines that were able to be used. While limited in scope, I was still excited to see functioning machines. In all my time working in Africa, I've never seen dialysis take place. In South Sudan, a country bigger than France and with a population around ten million people, there wasn't a single place to get dialysis. Dialysis centers are almost on every corner in the US, especially in my native South Texas, where there is so much uncontrolled diabetes and hypertension and therefore resultant kidney disease.

Otherwise, the weekend was spent catching up on sleep and petting cheetahs. Well, that's a bit of an exaggeration.  Only a small amount of time was spent petting cheetahs. We visited the wildlife preserve that's located about a block away from our house in Kisumu. They have free roaming vervet monkeys and impala (can you imagine that they have animals named after cars??), as well as a whole host of other animals in cages - ostrich, white rhino, water buffalo, unicorns, etc. We even got to enter the cheetah cage and pet them for a minute. It was all great until our guide accidentally stepped on one of their paws while Luke was petting one of their heads. That got everyone's blood pumping. Also realized as we were leaving the cage that the guide expected quite a big tip for about 60 seconds worth of cheetah time. Oh well, I guess that's still cheaper than our potential hospital bill from cheetah mauling. All's well that ends well.