Athi River, one day in April 2021, 8.00 a.m., 27 °C:
“It’s cold today” is how Jairos, one of the 16 employees at Fanaka Medical Center, greets me. The outpatient clinic was opened just under a year ago and I am the 4th doctor in the project. A lot of things still need to be adjusted, but the team works well together, the outpatient clinic is accepted by the slum population, patient numbers are rising steadily and everyone is motivated. Sitting on beer benches under a corrugated iron roof, the first patients are already waiting. I wipe the dust off my shoes with a damp cloth – we’re ready to go.
A gaunt, ill-looking man in his early 40s introduces himself. “Coughing – especially when it’s cold”. I’ve been here for 5 weeks and I still don’t understand when it’s really cold on the equator. But well, coughing since when – “last year”. Probably not corona then. I’m thinking tuberculosis. Maybe it’s also the consequences of cooking over kerosene, or…? The blood count gives little information. An X-ray has to be paid for by the patient and is expensive. So, first send in the sputum and wait and see.
Door open – door closed. A mother brings her little girl to us. Hope has diarrhea. Her mom puts her down on the examination table and leaves the rest to me. So I unwrap her from the thick blanket, take off her jacket and sweater – with a long-sleeved shirt and bodysuit underneath. She also has a woolly hat. I examine her: her stomach is inconspicuous, no signs of a serious lack of fluids. The mother can pick up an electrolyte solution from our pharmacist. If Hope drinks well, she can go home.
Elisa, my translator, gives me the next ambulance card – rash. Any known allergies? “Yes, cold”
Eight hours and 130 patients later, the gate to Fanaka Medical Center is closed. Dr. Friedemann – my German colleague – and I walk back home along the hot and dusty Mombasa Road. At the end of the day, our heads are buzzing with thoughts. This time we philosophize about understanding and accepting some things we don’t understand. Soon the sun will set over the Kanaani slum and I hope that today we have managed to make this – to me so ominous – cold at least a little more bearable.
