A day in the Life of JARON
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
‘I am the Confessor, and you are the Sinner….so you will stand as tradition dictates!’
- Run a name search to ensure that my desired business name isn’t already taken + sh. 100.
- Fill out a “Statement of Particulars” form detailing my info and submit it + sh. 900.
- Await a Certificate of Registration once all the stuff has been approved.
- Change the proposed name of my business and run another name search in the hope that it’s not taken.
- Keep my desired name and just get a lawyer to blast through this process and wanton bureaucracy, and get me what I need.
- Totally digitize the name search process. There is no need to have a bunch of people sweating it out to line up in a stuffy hall to submit a piece of paper. Have the database of registered businesses online and allow people to cross-check their potential business names against that list FOR FREE!
This would speed up the name search process by eliminating the 2 day wait time.
- You definitely need to improve your website to make it easy for prospective business people (most of whom are new to the procedures) to find the pre-requisite forms (along with examples of PROPERLY FILLED-OUT FORMS), conventions for naming business and other rules and regulations.
Think about it this way: A headache saved in having matters elucidated to the public, is a headache saved in having to peruse through incorrectly filled forms and submissions.
I had the opportunity to attend BarCamp 2013, which was jointly held at NaiLab and the iHub sometimes late this past August. From previous internet searches of those two venues, I knew that they mostly dealt with ICT ventures, so I was a bit apprehensive initially about attending because I figured it would mainly centre on geek-speak for computer folk. However, they stated that the theme for the event would be Kenya’s 50 years thus far, and what we could expect from the next 50…so I figured the topics would be more inclusive.
- We want free maternity and obstetric care for our fledgling mothers, but don’t bother to get rid of polygamy or reduce the markedly high average birth rate (5 kids per family). We don’t even add to the the number of professionals or health facilities, stretched as they already are, that are meant to deal with the sudden influx of new patients
- We want to give our children laptops to aid with their learning, without appreciating that a lot of children are actually learning in schools that have no walls to speak of (in extreme cases, under trees).
- We award our Members of Parliament First World salaries in a country with a meager Third World GDP, whilst refusing to effect pay rises for essential staff like Doctors, Nurses, Police, Teachers, Pilots, Firemen, etc.
Labels: Man of Steel Review