For the first time in my life I had the opportunity to do some CSR (Corporate Social Responsibility) at a "medical camp". I remember I had initially witnessed a couple of those clinics run at my local church (St. Elizabeth Ann Seton) while I was still doing my Pre-Med in Grantham, PA, and hoped it was something I could do once I obtained my medical degree. Well, truth be told, it's been almost 6 years and a month between actually getting the degree and me doing the CSR. Part of that might be down to procrastination, but the bigger portion probably has to do with my proclivities towards giving. I'm not saying that I'm stingy, but I always feel like I never give enough...like I never can give enough. With such an internal monologue going on in my head, it's very easy to psyche myself out of giving. I appreciate the chance to give money when the occasion calls for it, but even more than that, I prefer to give my time. I don't put a premium on my time, and I'm still relatively young and devoid of any major commitments, so I have time to spare.
I used the Bill Cosby pic at the start despite all that's happened with him lately because you can't knock the humanitarian work that he did. That little pic was a big part of my past because it was something I remember encountering in the back of Marvel comics. It is also my own personal mantra because I feel more comfortable donating my time more than anything else.
It turns out that you can achieve a lot if you have the right team, and in this regard I have to thank the Nairobi Hospital team that put it together. We had nurses, nutritionists, Lab techs, doctors, marketers and customer service reps working to make the whole experience seamless. It was my day off, but I was glad to be using all this knowledge I've accumulated to give back to the community. The medical CSR opportunity gave me the chance to interact with a bigger subset of the Kenyan populace than I have of late. It serves to remind me of the need that exists at the grassroots level.
My most defining experience of the day was actually a paediatric case.
A grandmother shows up with her 7-year old granddaughter who is having a fit of coughing. So as I do the history taking, it turns out that the cough basically kept her up through the night; the cough has a diurnal variation (worse in the early morning and late evening), and it is worsened by cold weather. The child has been taken to hospitals, and usually receives a bunch of medications (last one being an antibiotic - Septrin), but the condition still recurs.
Off the bat, I'm pretty sure that the child is asthmatic, and on auscultating/listening to her chest, I hear the telltale rhonchi (wheeze); clearly she just needs an inhaler (Ventolin/Salbutamol), and measures need to be taken to ensure she's kept warm to avoid the cold, which is a trigger for her asthma. This is where things start to get interesting: turns out that when the girl was younger, she had been given an inhaler, but the clinician had given it with the caveat that she not use the inhaler so much because she would eventually get "hooked" on it. (The clinician must've been missing from class when they discussed ATOPY 101).
To add insult to injury, we have the child's mother who ascribes to a "name it and claim it" brand of religion. I initially thought that this specific mantra only worked for drawing blessings to oneself. Turns out there's an extension to that kind of thinking: basically the mother felt that if she "named" the ailment, then that would be her accepting the devil's curse upon her child's life. So she just wanted to live life as if her child's condition didn't exist.
I hold myself from going off on a tirade about the double dose of ignorance, and ask my superiors to arrange for the child to be nebulized (they were able to do this at no charge to the patient). However, this was only one mere battle to be fought; since asthma is a recurrent condition, this child needed an inhaler, and occasional follow-ups to assess the adequacy of the treatment. The grandmother already understood the importance of the inhaler, but it was the mother - the principal guardian - who needed some kind of counselling to come to terms with her child's condition. Unfortunately, the mother could not be reached at that moment, which was sad because she could also have received the counselling for free.
I ended up giving the grandmother a prescription for the inhaler, and hoped that she would at least succeed in convincing the child's mother that asthma is a common condition that has reversible symptoms, and can usually be managed with medication; and importantly, the patient can live an essentially normal life. Sadly, this is a case which will undoubtedly be lost to my own personal follow-up.
All in all, it was quite a long day, but it was worth it. I at least saved people some money and time in terms of consultation, and as doctors often do, provided reassurance about benign symptoms that may have troubled their minds. I think I might just actively seek out more chances to volunteer in the days to come. It might be a token effort in the end, but it probably makes a world of difference to lots of people out there. So if you're still sitting on the fence about volunteering, despite how much you feel you have to offer, take the leap and do whatever small part you can.
God Bless
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