Kenya: rawness of living

[left: pus drained out of a client’s lungs by straight IV into the only drainage bag we could find on the island

below: our backyard in Sena: straight up cornfields]

Someone should tell the folks at San Francisco General Hospital that they’re wrong about something. San Francisco General Hospital is not “As Real as It Gets.” Sub-Saharan Africa is.

I wake up to the sound of twittering birds intermixed with roaring diesel engines without mufflers. I walk 4 km to work on a dirt path next to the highway, hopping over sewage, chickens and walking wide paths around cows and goats. In the mornings, I dodge boda bodas, regular bikes, slow pedestrians, tuk tuks, speed-demon matatus that swerve like crazy, giant buses and trucks spewing out black clouds of exhaust into my face. When I get to work, I thank all the higher beings in the world for sparing my life.

My sweat has dried, making the dust and dirt cling onto my skin for the rest of the day. The sun has already darkened my nose; the rest of my body is covered in the usual conservative Kenyan wanna-be Western attire. The blisters of my sandal-clad feet have already turned into calluses.

I then spend the day working with clinical officers and nurses who haven’t been paid for 2 months because their payor in Nairobi is slow, and it take 5-7 days for salary checks to clear at the local bank. I see clients (patients) who had to sell their family goat in order to have enough money to travel from their rural home to our clinic monthly. I see people who have obviously been ill for many years, but they wait till their disease is too advanced for them to handle at home. So there’s the mama who left her deep wound till her next scheduled visit. And the kid who came in with a giant mass in her neck, most likely a lymphoma. And the skeletal man, skin taut over his bony body with deeply sunken cheeks and eye sockets, who got tested only now, and said that he’d been previously “fine.” Somehow I doubted that.

Even the rain here is RAIN. It’s not the mealy half-hearted foggy drizzles that we get in San Francisco. It’s BAM! Late afternoon, and all the hydrogen in the sky collides with all the oxygen in the sky and falls on us. It beats us into submission. The entire insect world comes into your house for shelter, so you are covered in bug carcasses within a half-hour of the rain. And then it’s done. The sun comes back, the water dries up, and the land is ready for another storm the next day.

Life here is raw. There is little protection from the earth, creatures of all types, the dirt of industrialism. There is no shield from the scammers and the neediest in the world. Most non-black folk here in Kenya try to hide from these elements. They buy cars and ridiculously large houses. They hire black Kenyans to do their housework and take care of their children but treat them poorly to further mark the difference (and thus to hide even more). But people who do that aren’t living fully.

It feels good to live more raw. It’s harder in many ways, but so is truly living.