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Electricity is something I rely on. Lights, hair dryers, hair straighteners, televisions, telephones, computers, etc. are items I use on a daily basis. There is electricity in Africa, and it is a bit more reliable than it was in Haiti. However, this morning the hum of generators woke us up, and intermittent electricity and generator power made the morning shower process even more interesting. It amazes me how something as simple as electricity is not as developed in these other countries.

Breakfast was the normal eggs, sausage, bread and fruit. And then we headed up for the fourth day of the clinic. By the time we arrived at Botoro Lutheran Church, there were at least 200 people already waiting for us to arrive, and we are told by the night guard that some arrived as early as 4:00 AM! The registration group devised a new plan for today to try and keep order to the line of those people waiting to be seen. Today we handed out 200 numbers to people, and we saw the people in order. If a person did not have a number, they were not seen. And these Kenyan people are tricky! They tried creating their own numbers, sneaking in the back doors, asking favors of the bishop and pastors and reporting horrible illnesses in order to be seen.

I think we are starting to feel some compassion fatigue at times. We really and truly want to help these people, but their conniving maneuvers, yelling, pushing and shoving is just a bit much to handle. On the other hand, I feel awful that we are turning away so many people at the end of each day because we do not have time to see them. There is only so much we can do. I also am concerned about the people who wait all day to be seen and never eat or drink water the entire day. There is great need in the Kisii community for health care.

The new numbering system did work well, and the day ran much smoother. I was in triage again today and saw many patients with similar ailments. The standard list for each adult person is headache, back pain, joint pain and stomach ache. I jest, but there really are some very sick people in need of care. For instance, today we saw our first case of severe malnutrition. The mother brought in her four-year-old son who only weighed fourteen pounds. His appearance was remarkable. The child has never walked, talked, or been able to feed himself. From what we can gather, the mother leaves the child at home during the day to go out and work. We are not sure the child even receives one meal a day. Due to poverty, the mother is unable to provide food. The doctors believe most of the child's neurological and health ailments are due to malnutrition, perhaps even since birth. Thankfully, we involved a social worker, and the child was taken to the hospital where he is currently being treated. The Kenyans we are working with are just appalled that the community and neighbors of this child did not step in to help. Ignorance, again, is a large health issue here. Other interesting cases seen today include diabetic foot ulcers, hook worm, ringworm, infected wounds, possible undiagnosed breast cancer and many very sick people.

It was another successful day as we saw 200 people between 9:00 AM and 5:30 PM. There was a brief lunch break for an interesting stew that contained potatoes, carrots and whole mini bananas (I still prefer my bananas raw!). At the end of the day there were still over 200 people waiting to be seen. The registration team handed out 150 numbers to people and family units for tomorrow, and we are guessing we sent another hundred people home with very little hope of being seen while we are here this week. The health needs here are almost heart breaking. Some people want to be seen just to receive the free medications, but there are many other people who are truly ill and need the medical assistance. Education for basic hygiene and treatment is a large concern to us.

The end of the day is always quite enjoyable to me. The children just seem to appear, and they come to goggle at us, take pictures with us and play with us. I am sure we, as white people, are quite foreign to them. Their faces are filled with such joy and happiness. The people here lead simple lives, but they truly seem to be happy under their stern exteriors. The children are the epitome of happiness and joy.

Dinner was the Kenyan fare of rice, french fries, chicken, fried fish and ugali, and tonight we are all trying to recuperate from some very long days. Hopefully tomorrow will bring a successful close to our clinic days here. And we pray that God will continue to guide, bless, and help these people in the Kisii communities we are serving.

Saint John's member Kimberly Pepmiller is in Africa through July 25 with ten other doctors and nurses, lending her medical skills at clinics in Kisii, Kenya, operated by the Lutheran Church—Missouri Synod's Mercy Medical Team.