When Africans get sick...

(JOURNAL DATE 3/16/2010)

...they really get sick. I did rounds, clinic and theater today and noticed just how bad and advanced these disease processes are. Of course, this is likely secondary to lack of finances and access to care for the Kenyans. For one, none of these people have anything close to insurance. In fact, almost 80-90% of Kenyans are uninsured and pay for health care entirely out of their pocket. Second, the majority of Kenyans have limited access to care. They do have public hospitals here, but they are slow, inefficient, and frankly provide substandard care. Most of the Kibera residents we serve at St. Mary's Mission Hospital understand that they will get better care here than at the larger public hospital, Kenyatta Memorial in Nairobi.

Back to the diseases. They see a lot of advanced cancer and most of the medical care provided for this is palliative. Esophageal, gastric and breast cancer is common and often terminal at diagnosis here. Interesting that I've seen so many gastric (stomach) cancers, the incidence in the US getting lower each decade. Also, they often don't stage the esophageal cancer. Unless the patient is very young, they almost make no effort to determine whether or not the patient could be saved with radical therapy. Additionally, there is extremely limited access to medical oncologist in Kenya, with the wait for chemotherapy often extended beyond the anticipated lifespan.

All of this without even mentioning HIV and tuberculosis. The rate of HIV in Kibera is around 40% and growing. This puts a tremendous burden on mission hospitals but also on the communities in which it is spreading. Many children in Kibera are orphaned (literally or metaphorically) and grow up with little adult influence. This has lead to elevated levels of sexual immorality and spread of disease - not only among the teenagers but vertical transmission to their offspring. Kibera has multiple generations of HIV positive families and then the problem becomes cyclic. Doesn't take a huge stretch of the imagination to realize that cycle won't break soon.

All in all, rounds this morning with nothing short of depressing. It's amazing how poor the conditions are and how little hope many of these people have. They are eager to hear about Jesus (and America) but they have trouble grasping why He would provide such acceptance of them with grace and mercy. I just want them to understand ... "To hang between two thieves in darkness, love thought you were worth it". (Nicole Nordeman)

ON THE LIGHTER SIDE OF EVAN

Today (yes, really today) Evan and I went for an inaugural 1-mile run. He begged me to take him running today, so finally I gave in. He was so proud (and so was I) that he actually ran a full mile with me. And not so slow: 12 min and 33 sec. Way to go Evan!!! Guess I'll be signing him up for the kids 1-mile runs now :0