Yellow House

A Day in the Life
By Martin Nafukho ,

Occupational Therapist
Education Assessment Resource Centre, Mumias

It is Friday March 30th, 2012.

The night before has been hot and still with stars ablaze in the dark. I had been out many times to watch the skies for any signs of rain; the weather man predicted it would be pouring by now. It has been an unusual year for a rural community which is heavily dependent on Mother Nature for survival. The rains that form the main stay of farming in this part of the world have delayed, and the weatherman despite his advice to brace for floods by mid-month has been wrong again. He is now saying there will be no rains after all.

The new moon is already 4 days in the sky adding to the light of the stars. As I stand I can hear the quiet hum of the sugar factory. The quiet is broken by a cacophony of sounds that once kept an American volunteer awake on her first night in Mumias. These bats make a sounds that led her to wonder why someone was ringing bells all night. The hyenas that used to roam and moan in the nights are no more, just as our cows will be if we do not get any rains soon.

My day starts at 5.30 am as the children wake up to go to school. I have to be awake too to cuddle call ‘mbembeleza’ the family cow to give us 2 tea cups of milk for our tea. With this we are much better than the urban people who may have the money but the milk from the commercial dairy has disappeared from the shops. I think the prolonged dry season has not only affected the planting, there is no grass for the animals in commercial farms. I soon get my cup of tea and by eight o’clock I am nearing my work place, the Education Assessment Resource Center (EARC).

The last two days I have been away on integrated supervision encouraging our colleagues at health centers and dispensaries to forget the recent threat by the health minister to sack them after striking for appalling work conditions and do the best in spite of the deficiencies of the system they work in. As an occupational therapist and a community health worker it is never easy to plan my work day ahead of time. Rarely will I get a proper referral from the doctor on what to do with the clients who pass through my place of work.

At nine o’clock on this morning, I get a call from a special needs teacher that a colleague recently had a bad motorcycle accident that left them with a compound fracture of right proximal tibia. On February 14th his fracture was fixed by plates and his doctor advised him to see the paramedic to make a back slab, but when he went to the paramedic they said they had no plaster of Paris. As the teacher had no more money left to buy the plaster of Paris needed, he just went home. The next time he went back they were on strike. He then called the doctor who told him to find a knee brace. At the chemist it was going for ksh 3000 (around $40), a price still out of reach. He had a doctor’s appointment scheduled but according to him the doctor had said he will chase him like a dog if he showed up without a brace so he didn’t go. From my examination the right knee had obviously deviated laterally and without a brace, all the plates will soon be of no value.

Coming to see us at a centre for children with disabilities was a last resort. He will hear nothing about us being a pediatric clinic only. He begged for help and though it was a day we were planning to go out for community outreach, his plea made us reschedule. There had been some small sized knee braces once donated by one of the Yellow house speech volunteers. We find that volunteers often come with an assortment of materials after asking around their places of work for supplies that are lying around unused. Though we have had this brace for a year, today it has its purpose. Although small, it is all we have and it is better than nothing.

After we are done with him, the mobile clinic vehicle belonging to the Kenya Association of the Physically Disabled arrives from Busia, 35 km away. Today we are going south of Mumias another 35 km away to provide follow up to community outreach made earlier this month. It will be another 40 minutes before we reach our destination, the community health workers have been calling incessantly to confirm if we shall be there. By noon we arrive at the first point, Bukaya Health Center. There is a 15 year old with epilepsy from a nearby school and a 7 year old boy born without upper limbs. The parents of the girl reveal that at one time she used get medication for her epilepsy here at the health center but lately the medicines have not been available. When they heard a team was coming they thought they might get some, but they prepare to leave disappointed. We ask the nurse to counsel them and we refer them to an epilepsy clinic at St Mary hospital.

The boy we have been seeing since he was one month old. He has been referred to a special boarding school, because the local schools rejected him as he has no hands. His father however does not have the 15000 (~$200) for boarding fees. We think the local education office, has probably not looked at the EARC report we wrote when the family came to see us initially. We promise to follow up with the local constituency or social development fund to see what can be done.

At this time I start to feel very tired, thinking of Africa my mother land, so much hope in its people so little done to help. It is now 1pm and the physiotherapist , an orthopedic tech volunteer and myself, who make up today’s mobile team move to another station. Some clients got tired and left but there are still children and their parents still waiting.

There is also a five year old girl who cries the whole night according to maternal report. She presents with communication difficulties. Apparently she had malaria resulting in convulsions 3 years ago and the problem has been ongoing since. We agree that the family can come with us in vehicle today so we can take them to a pediatrician, but it is getting late. They promise that next Wednesday they will come to the EARC so we can help them as we have a visiting speech therapist volunteer. Another client is 4 year old boy with bilateral club foot who was identified early but after a series of visits to nearest hospital for casting , they gave up the procedure because the paramedic started asking them to buy the plaster . It is now so bad he will need surgery review . This one is lucky, Jess Medland an occupational therapist who knows of us through Yellow House Children’s Services has raised funds to help such cases.

So the day has not been in vain , one among these will live to say something changed. What makes changes happen? Money really. We have the skills, the materials are available, our families just cannot afford them. We need people to commit to help with transportation costs (usually bus fares) and surgeries. The money pays not only for procedures, but for the hope that may have been lost and can be restored for these kids. The hope that there is something better, that people do care.

The nagging thought as we head back to Mumias and Busia at 5pm is what can be done to help people with epilepsy, convulsions in the rural out flung areas, if they will need speech therapy like the 5 year old girl how can she access the EARC services 30 Km away, even if the parent were willing to help ?

My work day draws to a close. More questions than answers, more problems than solutions. I look forward to returning to my family, my home, to the blessings of my small children and their good health.