“On Saturday evening I was picked up at the airport by the friendly driver and then taken to the house where the short-term doctors live.
On Monday morning, after breakfast with our colleagues, we took the minivan to the Baraka Medical Center in the Mathare Valley slum.
After a short tour and getting to know each other, I was allocated my own examination room with a translator. I was then able to start treating patients.
The process takes some getting used to at first; direct communication with patients is not possible in the vast majority of cases due to the language barrier. A brief medical history is taken by the translator, who then translates any further questions. The translators speak very good English with a wide range of medical vocabulary. The patients have a treatment card in the form of stapled A4 pages on which the current medical history, diagnosis and treatment as well as the time of re-presentation are handwritten at each presentation.
In Baraka there is also the possibility for routine laboratory examinations including examinations of stool and urine samples as well as ultrasound. X-ray examinations are also possible on referral.
Many patients come with clinical pictures that are familiar to me, but the treatment options differ from those I am familiar with. The patients receive the prescribed medication from the Baraka Medical Center pharmacy.
Many patients present with multiple complaints, most of which have been present for some time. Visits to the doctor are often postponed due to family or work commitments. Patients often come repeatedly with the same symptoms.
Of course, there are also many diseases that are not commonplace for European doctors, such as malaria, tuberculosis or worm diseases, but also old broken bones and many burns.
Patients who contact a doctor far too late, sometimes with advanced cancer, are a challenge. Many patients are also HIV-positive.
The HIV test is part of the standard treatment in Mathare. As a result, one of the patients is diagnosed with an HIV infection approximately every second day. Fortunately, there is an HIV program in Baraka where patients are admitted immediately and receive medication. However, the success of the therapy is heavily dependent on patient compliance. They have to attend check-ups to receive new rations of tablets. Unfortunately, there are many patients who only attend these scheduled check-ups weeks later or not at all.
Some patients cannot be adequately treated in Baraka or require further diagnostics in a hospital, unfortunately most patients cannot afford these measures.
Acutely ill patients can be transferred by ambulance to one of the hospitals in Nairobi, but the patient’s further course is not usually known….
At 17:00 the Baraka Medical Center closes its doors and most of the doctors prefer to walk home so that they can take in the hustle and bustle of Mathare every day.
I always enjoyed the daily dinner together in the medical center. We discussed the exciting cases and sad events of the day with our colleagues and brought the day to a pleasant close.
You are confronted with full waiting rooms every day and patients are treated to the best of their ability. Nevertheless, I always had in mind how easy it would be to treat certain illnesses here in Austria. Unfortunately, this option is not available to the inhabitants of the Mathare Valley slum. But in the very familiar environment of the Baraka Health Center, where all the short-term doctors are warmly welcomed and there is always a cheerful atmosphere during lunch breaks, the stressful events fade into the background and time flies by. I am always amazed at how many experiences, moving patient stories and adventures have enriched me in these 6 weeks and I am glad to have taken on this challenge.”
