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December 17, 2003
OU-COM medical mission to Kenya challenges physician and students alike
By Michael Weiser

The SHARE (Student Health Assistance Rural Experience) Kenya began in 1994 at the insistence of the little voice inside the head of Benson S. Bonyo, D.O., then an OU-COM medical student from Kenya.

The voice, whispering to Bonyo in his Luo tribal language, said, "Wadok Kenya. Wangaya dwaro jothieth." It told him, "Return to Kenya. Wangaya needs doctors." Wangaya, Bonyo's home, a small farming village near Lake Victoria on Kenya's southwestern border, is one of the poorest and unhealthiest in the country. The nearest medical clinic is seven miles away and the closest hospital is a half-day's walk to the city of Kisumu.

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Feeling the responsibility to return to his country and care for his people, Bonyo jokingly said to three of his medical school friends, "Let's go to Kenya." Surprisingly they replied, "That's not a bad idea."

In December 1994, Bonyo and 14 of his fellow students traveled to Bonyo's homeland. While there, the team treated more than 1,000 patients and encountered a wide variety of serious illnesses including malaria, cholera, HIV/AIDS, tuberculosis, measles, parasitic diseases and pneumonia. Although it took three years to return after that initial trip, the SHARE Kenya trip is now an international medical rotation at OU-COM.

Each year's trip lasts between three and four weeks, beginning just before the Thanksgiving holiday and ending before the December holiday season. This year's SHARE Kenya team, led by Daniel Marazon, D.O., OU-COM associate professor of family medicine and academic head of the program, was comprised of eight osteopathic medical students, two pharmacy students, one pre-med student, a dietician, two family physicians, an orthopedic surgeon, an emergency medicine physician and three lay people for support.

Each day, the medical teams usually see between 200 and 300 patients. Many of these patients have traveled great distances to see the visiting medical team, and while many are severely ill, they endure long lines to receive treatment. Each morning patients receive a number and many must wait eight hours to be seen.

"One year, one man was so weak he couldn't fight for a place in line, so he slept out side the clinic all night. He wanted to be first in line the next morning," says Bonyo. "Anyone who arrived at the clinic after 8 a.m. could not be seen."

As of Dec. 8, Marazon's e-mail communication mentioned, "thus far there have been no untoward incidents" with regard to this year's team members and the trip seems to have been a great success.

"I estimate we saw well over 5,000 patients," says Marazon. "Everyone became quite proficient in diagnosing the tropical diseases of malaria, dysentery and typhoid fever. The wound care directed by Drs. Barry Greenberg, M.D., [an orthopedic surgeon from Crystal Clinic in Akron, Ohio] and Caroline Wilson, M.D., [an emergency medical physician at Akron City Hospital] did a double workload to educate a few locals to be 'wound care technicians'."

According to Marazon, the villagers were given small suitcases purchased from the local market and provided a first class wound care [kit] supplied from the stash of medical equipment brought from the USA. "The technicians' intention is to make rounds on their bicycles to villages. This is the first time SHARE Kenya has trained locals and provided equipment to sustain health care once we depart," he says.

The medical supplies provided by the SHARE Kenya trip come from a variety of sources. Some supplies are purchased after the team reaches Kenya, but some travel with the team from the states.

"Locally, O'Bleness Memorial Hospital gives about $1,000 worth of medicines every year. The hospital also contributes dressings and materials from the one-time use sterile packets that would normally be thrown away. We use these materials in the wound care room, similar to an ER," says Marazon. "Each person is allowed to bring a 40-pound carryon aboard the plane. That's where the travelers pack their clothes. They use the checked luggage limit of 70 pounds per person to transport supplies and medicines."

In addition to seeing patients, the team usually takes on a specific project to improve the conditions of the Kenyan community. The previous teams were greatly concerned about the village's unsafe drinking water, which is obtained from drainage ditches and shallow water wells.

"This year's big project was to fund the drilling and installation of a deep-water (100 feet deep) well on land donated by Dr. Bonyo's father. We only had enough money for a hand pump, maybe next year we will run electricity to the property and purchase an electric pump at cost of 50,000 shillings ($720US)," says Marazon.

But Bonyo continues to envision new ways to help this part of Kenya with his plans to build an eight-room clinic on his father's donated land. "It will have a pharmacy, wound care, three exam rooms and two observation rooms with two beds each," says Marazon.

The SHARE Kenya team returns home this week with eyes open to another world of medicine that took them out of the technologically supported comfort zone of practice in the United States, and instead was challenged to rely upon their basic, hands-on diagnostic skills.

Michael A. Weiser, M.S., is the associate director of communication for the College of Osteopathic Medicine.

 

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