A day in the Life of JARON
I've neglected to write anything for quite sometime, and that was mainly because of all the stress that I went through during my stint in the Obstetrics/Gynaecology Department, but I've finally moved on to a slightly less hectic department: Internal Med.
Suffice it to say, the experience did nothing to sway me away from considering a specialty in Surgery. (I've only just managed to get over the episode of PTSD induced by the whole experience.
While I have been neglecting the blog, I managed to finally open a Tumblr account - http://wmu1ah.tumblr.com - and started to do something I should have done 2 years ago: putting the 'Compendium' pictures of the 1st Affiliated Hospital online (similar to the one shown on this post). During my last year at Medical school, a group of us invested hours and hours of our time putting together this massive project that would highlight the new 3,300 bed hospital and, in turn, bring much need attention to our medical school.
Personally, that project is all at once one of my greatest accomplishments and greatest failures. At this point, it's easier to ruminate on the failure, because, honestly, these pictures are coming out 2 years too late; I can't even begin to think of all the other compiled work that is sitting on multiple computers, idle, serving no useful purpose. Whatever the long story behind the whole process, I'm glad that I still have Tumblr to show some semblance of what we hoped to achieve.
My most heartfelt thanks go to all members of Compendium who helped with all the major lifting, particularly Hafiz, our trusty photographer, whose great skill shines through in this particular Tumblr.
Now that I have this bit of work off my chest, I can find another hobby to occupy my mind.
I had usually skipped this piece whenever I came across it in my playlist. The long drag from Michael Brecker's sax usually implied to me that this would be a depressing piece (...and this one certainly is long, coming in at a full 13.5 minutes).
Thankfully, one day I just let the shuffle button do its thing in my PMG playlists, and I had a chance to listen to the piece in its entirety. It is by all means exquisite; a ballad perfectly crafted. Starting out with the song's chorus framed by an ethereal pipe synth portion, Michael Brecker paints us an eloquent picture, and in a quickening of pace, Mr. Metheny adds yet more pastels to the song. (Love that rubato!)
If memory serves me right, it was Pat who wrote this song, but from listening to it, it's clear that the good relationship he had with his late friend allowed them to concoct pure magic. Mike Brecker is front-and-centre on this tune, but Pat is never far behind - each of them coming in to accentuate different portions of the song. Every bit of this song just works. If the title of the song is anything to go by, they really expressed their gratitude as sincerely as could possibly be done. And in turn, I thank God, everyday, for this music which conveys sentiments that cannot be described adequately through wording.
Everyday, Father, I thank you.
This is the second time I'm having to deal with the Registrar of Companies at Sheria House, and I cannot claim that the experience is any less painful than the last time. In my previous post, I had mentioned that I already knew the necessary steps required to initiate my business. As usual, the lynch pin was the people manning the counters at Sheria House.
This past Monday, armed with a new name for the business - "Aykornia" or "Aykornium" - I wanted to run the prerequisite name search. Would you believe the Registrar has only one desk dedicated to this process (Counter 1 - File Perusal/Name Preservation); to cap it off, at 10.30am the employee-in-charge of the counter just got up and left, leaving a growing number of us in a queue stranded! And these things aren't complete unless they come in a
trifecta: some of the employees from the other counters who glanced at my desired company name told me that my company name HAD to consist of at least 2 words.
My complaint concerning these 3 issues remain unchanged from my last post, and I'll put them down here again. First, Counter 1 is redundant and can literally be manned by even a trained high school student who would only be required to receive your application and give you a slip allowing you to pay for the transaction. It would even be more effective to actually digitize the procedure to ease the whole process and decongest the registration hall. These two mere measures would free up the people manning the counter to 'possibly' make themselves useful somewhere else.
And I've said it once,and I'll say it again: some sort of guide needs to be published to assist fledgling entrepreneurs concerning the idiosyncratic rules governing setting up businesses. I am tired of having random clerks randomly chipping in with ad hoc rules that complicate an already complex and infuriating process. I would like to think that any worker worth their salt would strive to improve the processes associated with thir work stations, but it is becoming clear that some of these civil revel in the confusion; others just do not care enough to want to change anything.
The last time I went to Sheria House, a guard at the gate approached me and basically offered to 'expedite' the process if I basically 'greased his fingers'. The corollary is that if his fingers are 'greased', someone else on the inside is also having their fingers 'greased'. The only other option is to have a lawyer bulldoze through this process for you, and that certainly doesn't come cheap.
So for the clerks, the modus operandi is just frustrate! frustrate! frustrate! the common mwananchi.
I hear people talk about how easy it is to start a business in Rwanda - a maximum 3 days (even for foreigners) to have the legal documentation in their hands. I compare this to Kenya and think that there's nothing really special involved here. Just Discipline and the ability to understand that allowing business to flourish in Kenya is good for the country as a whole. However, if the current civil servants can't understand that, they need to be sent packing instead of positioning themselves as stumbling blocks in everyone else's path.
That's my 2 cents for today. God help us all (especially if we have to go to the Registrar of Companies offices)
Since discovering it late last year, I must admit that Kickstarter has evolved to become a major part of my daily internet read. I can't lie, their webpage design endears itself to many allowing for many joyous hours of reading pleasure. Far better than that though is the varied number of stories of mastery of a myriad of crafts, and the great amount of work that goes into crafting each product.
I usually spend my time perusing 3 different categories: Design, Comics and Technology; there are a lot more sections to pick from, but I find myself drawn to these ones in particular. There is truth to the saying, "Necessity is the mother of all invention"; as long as there will be a ton of problems to solve, there will always be forward-thinking innovators who can anticipate solutions to those same problems. The big question is whether they can make any money off those solutions.
One project that was particularly elegant in design was the Muse Clock by Nate Borozinski. True, this is merely a wall mounted clock, but the new spin he took on this idea is an artistic marvel.
However, my ultimate favourite has to be Palm Republik by Peisy. Malaysia, the country she hails from, produces a lot of the world's Oil Palm, which thus results in a lot of biomass waste. Malaysia, in the same vein, is also researching into various ways of utilizing this waste - and their most promising product is Palm Paper. Peisy took this one step further, building a company around novelty designs made from Palm Paper.
Just like Palm Republik, I too have the idea of moulding the concepts I laid out in "The Hyacinth Economy" into a business (tentatively titled "The Hyacinth Lab"). Those aspirations will have to be postponed because my current medical internship does not leave me with any spare time to pursue the needed research...but at least the dream is still alive and kicking.
The Comics section is a visual joy because the authors usually leave snippets of their works in progress in form of comic pages, illustrations and synopsis accounts. I've had the beginnings of a graphic novel swirling around in my mind for 2 years now, so with a little inspiration I think I could put pen to paper and come up with quite a delightful read. With a finished story, I could start looking for an illustrator of repute.
But as the aspirations wait, at least I'm being inspired a little more everyday. It's been almost 9 years since I wrote my paper on Hyacinth & Phytoremediation; about 1.5 years ago, I finished my paper of "The Hyacinth Economy", and now I can picture it as a potential full-fledged business. Who knows! Sooner, rather than later, I just might throw my hand in along with the rest of the entrepreneurs; but till that day comes, at least I've got Kickstarter.
I was simply astounded how we never ended up with any floods around here. Sometimes the place is practically bone-dry in the morning; and worst of all, at my old place we always had water shortages (mind-boggling)!
Rain is a Catch-22 kind of thing: you really suffer if it doesn't rain enough, but, then when your prayers are answered and it finally rains, then you have to scamper away and keep from getting drenched; in addition, if your paths are poorly paved, then you have to deal with lots of mud everywhere; and, if drainage in your area is poor, then you have flooding and stagnating pools of water all around. It's the kind of thing to keep people cursing both in-season and out-of-season.
There's no getting away from the fact that rain is life; and it's not like human comfort is the gold standard for all things beneficial, but I would love for these two seemingly disparate entities (beneficial water & human enjoyment) to come together for once. I remember as a child that there was no stopping me from running in the rain and playing in puddles. Pretty sure the farmers rejoice too, because it means their crops get to flourish. I feel that most people, however, don't fall into these two classes, but there's still a way to reach out to everyone.
I am no artist, in any sense of the word,...but I do have artistic sentiments aplenty. My current fixation revolves around giving a practical impression of beauty to each rain storm. Rain is already inherently beautiful, if you have the comfort of watching it from a dry sheltered spot. What I'm aiming for is a monument that can be appreciated at anytime, but which would be specially animated by a rainstorm. It could be something as simple as a statue that becomes a functional fountain in times of rain; or maybe something resembling a turbine, whose blades could be spun by the action of moving water, lending movement to another very visible piece.
One item I found while leafing though "Street Furniture" by Chris van Uffelen was particularly inspiring: it consisted of two installations by an artist - Stacy Levy - who used a portion of sidewalk art/map to highlight the watershed of the locale. Once it rained, the flowing water accentuated the lakes & rivers, turning the map into a great focal point. These two installations are known as "Water Map" & "Ridge and Valley".
So for now, I have an inkling of a vision in my mind. Maybe someday I can pair up with someone who can bring it to fruition (...technically anyone who reads this). In the meantime, just thanking God for the rain, and hoping for a sprinkling of some of that childhood innocence; the kind that kept me enthralled by the beauty of the rain.
Addendum: while going through Stacy Levy's site, I found yet another piece - Arroyo - built around this same rain motif. It's one I would really love to explore with local artists.
As a fledgling Medical Officer intern, barely 2 months into my 1-year internship, I knew it would only be a matter of time before a strike came calling along. Actually the seeds of a strike never are too far away around here. I at least expected the strike would involve this unnecessarily hurried push that the counties are making towards devolving healthcare (practically a whole 2 years ahead of schedule). Kenyan institutions (particularly governmental ones) are not renowned for their efficiency; thus the general consensus is that devoid of proper systems, they just want to gobble up the medical funds (more speculation on that at another point in time).
This current juncture finds me dealing with a problem rooted in the old health system. We have an old tradition here, probably retained from colonial times, whereby you don't get paid for the first 3 months of work. After that, you receive the money for those 3 months in a big lump sum. I'm not exactly fond of this system considering that I was plucked from my usual stomping ground and deposited 6 hours drive away in Kisii, a town which I had barely passed through twice before. Even worse was the fact that I was only given a mere week in which to finalize all formalities, pack up my belongings, find a new house, and to be ready to report for duty. My Medical Superintendent basically told me that there was no way he could give me any more time to sort myself out because he had basically put me on payroll from the moment I showed up.
To tell you the truth, I felt the whole introductory portion could've been handled better, but then I was grateful to at least have a job offer. I didn't want to end up like my friends who had to wait a whole year before they were posted in April of this year. I'm glad my family cushioned my transition with all their encouragement and generous funding, which still continues till today.
However, it feels painful for the government to renege on an agreement like this. The current excuse they're using is that they have to weed out any 'Ghost Workers', so they basically have to show up at all internship centres to do a PHYSICAL head count of the interns. I get some of their logic, but it just boggles my mind that this is the same government that was supposedly elected on a "Digital" platform, yet they are just as inefficient as previous regimes. People might think I'm criticizing for critisicm's sake, but for your information I've had to submit piles of paperwork (going as far back as my primary school leaving certificate), all of which had to be filed with both the County and National Governments. It is unreasonable that I thus have to wait for officials from Nairobi - a whole 6 hours away - to complete their week-long or month-long (whichever) trip around this country to come seek me out.
Any other stories coming up about lateness in releasing funds are even harder to stomach considering the amount of funds wasted on vanity-affairs of our politicians or the fiscal irresponsibility displayed by government coffers. It is worrying that this is how one of the most essential services in the country, catering to the vast number of people unable to buy insurance, is run. They owe the people more than that...they owe the medical fraternity more than that. No professionals spend more hours in the service of the public, exposed to death and the deadliest of diseases on a regular basis, and still come out as under-appreciated.
There is great need to reform the public health system, if only for the simple reason that all citizens - rich or poor - could possibly end up as our patients. People forget that should they become incapacitated and have the misfortune to lose their wallets/purses containing their identification papers, premium health cards, etc., their destination is bound to be the public hospitals. That should be a scary notion for anyone to entertain under the current circumstances; you can't expect frustrated overworked workers to deliver the kind of services you would be proud of, so more needs to be done to relieve what is already a massively stressful job.
I'm not proud of the strike at all, but I'll follow up with it to give my fellow clinicians - who've been at this a whopping 4 months! - the numbers they need to make a painfully obvious point. In 5 days, hopefully this strike will be a thing of past, and I can then get back to my Surgical rotation, which I live for. Until then, I get a little "me-time" for myself. God Bless
Warm greetings to everyone out there. My current pre-internship at one of Nairobi’s District Hospitals currently occupies a lot of my time (…and let’s not even get into the 3-4 hours I spend in traffic each day), and so it is ideal that I should give you a slice of exactly what it entails.
Now, my previous pre-internship was at Kenya’s main referral hospital – The Kenyatta National Hospital (KNH) – and, suffice it to say, it was an eye-opening experience. Having only been to private hospitals anytime I’ve been ill, Kenyatta Hospital afforded me a chance to see the best the public health sector had to offer, which surprisingly is alright. KNH is usually in the headlines for all the wrong reasons, but it is a creature of wrongful circumstance; given the right kind of resources and backed by adequate political will, KNH could rightfully live up to its reputations as “East & Central Africa’s Largest Referral Hospital”.
True to my nature, while I was at KNH, I complained about the inefficiencies that I came across; however, I usually complain about things that, in my opinion, are rather easy fixes …surely there can’t be anything more frustrating than being pummeled by easily solvable problems. But as my friend Maria would keep on telling me, there is definitely much worse that I could be facing at Kenya’s myriad public hospitals; and after this stint at the District Hospital, I can see that she was totally right.
The public health system is understaffed, overwhelmed and faces shortages of essential drugs, equipment and linen that are required to save lives …or at least just make it more manageable during the convalescence period. One source of inefficiency is the crux of this blog, and it is by nature more of a ‘medical speak’ vs ‘layman’ conundrum. Every day at the hospital, we are faced with patients suffering from diseases like Diabetes, HIV or TB, and in one way or another the situation tends to play out the same. In treating any sort of chronic disease, the clinician needs to determine the history and severity of the disease condition, determine a baseline for the patient’s health parameters since the inception of treatment, and come up with the best drug regimen for the disease at hand.
In the case of HIV/AIDS, the doctor is looking for the date of the patient’s HIV diagnosis, presenting complaint (Skin lesions, TB, Meningitis, etc), CD4 count & Viral Load, and Anti-Retroviral medication (ARVs). To a clinician this is just the nature of the business; however, patients are typically plagued by a bunch of problems, not least of which is confusion/denial about their HIV diagnosis, ignorance of their most recent CD4 counts or viral load values, and forgetfulness concerning their current drug regimen. Again, in this regard, I can’t really blame the patients because a lot of them have a very limited grasp of the medical concepts behind their problem and its relevant medication; it is also a great exercise in wishful thinking to expect them to remember laboratory values for tests that were carried out almost 6 months prior to the juncture at which you encounter them at the hospital. One last problem is that the patients usually migrate to different parts of the country, meaning their condition is handled at various Comprehensive Care Centres (CCCs), and between these centres they usually tag along a tattered small blue card that relays some information concerning their status.
Using only HIV as an example, you can get a semblance of what clinicians have to deal with when treating chronic conditions at the hospital; things like Hepatitis, Diabetes, TB, Cancer, Chronic Lung Disease or Autoimmune conditions. Since the educational levels of patients runs the full gamut from illiterate to well educated, I think some measure should be put in place to simplify this whole process, entrusting the specialized details to the medical professionals so that treatment need not be hindered by any of the patient factors I have previously listed.
The best solution to this, I believe, would be the creation of a Chronic Conditions Card (CC Card). This would be a machine readable card – that uses the patient’s ID Number as a keyword - that would store the patient’s relevant details, Disease vital statistics and current drug regimen information. This would ensure that the details of any patient suffering from a chronic disease would be handled through a digital database and should be available to any clinician when required.
As we strive to gain some control over Chronic diseases – both communicable (Hepatitis, TB, HIV) and non-communicable (Diabetes, Autoimmune conditions, Cancer) – this notion of a CC Card and the associated database would give us a clear-cut method of tallying these disease sufferers, thus giving us an estimate of the kind of resources and financing that need to be put towards alleviating them.
The biggest hindrance to rolling out this card is probably the limited computer availability in most of Kenya’s hospitals. This would be one of those areas where political will could really make a big difference. I daresay that a mere fraction of the money intended to roll out The Primary School Laptops project would be enough to minimally computerize the country’s hospitals towards this end. In the short term, I’m pretty sure someone with basic IT skills could find some way to make a very basic mobile phone app that could interface with a national database, thus relaying the results where needed. It’s all still a basic idea right now, but I’m sure it is very workable and would save lives in the long run (which is the meat-and-potatoes of medical practice, in any case). Hope you have a great day. God Bless