Monthly Archives: August 2011

Hernando Garzon, MD, Arrives in East Africa; Helping the ‘Bottom Billion’

August 27, 2011

For those of you who may not be aware, I am working with Relief International doing a needs assessment and program development for a humanitarian response to the drought/famine in East Africa.

I arrived safely to Nairobi a few days ago, and expect to be here for just under three weeks.  I expect my work to be focused on Somalia and Kenya, although Ethiopia remains a possibility. Relief International has had an existing nutrition and health program in the city of Galkayo, Somalia,  since 2007.

Galkayo is in central Somalia and at the edge of the areas currently declared in famine.  Recent reports estimate a seasonal crop in Somalia this year of only 17 percent of the past 10-year average.  For this and many other reasons, the famine is expected to spread before it gets better.  My work in Somalia will be based on looking to augment the existing programs there in nutrition and health, and we are already underway in establishing additional funding from UNICEF to do so.  My work in Kenya will be around evaluating areas that are affected by drought and considered high food insecurity areas, and are currently felt to be under served by international NGOs.  We hope to establish health and nutrition programs in Kenya as well.

After a few more days to get my bearings, connect with contacts and attend meetings in Nairobi, I expect to spend time in the field, both in Somalia and in rural areas of Kenya.

The attached photo is from a recent assessment in the Dadaab refugee camp in eastern Kenya.  With more than 12 million people at risk of starvation, this crisis is magnitudes larger than other disasters which have seemed large to us, including the Haiti earthquake, the Japan earthquake/Tsunami, the Southeast Asia Tsunami, etc.

The people affected by this crisis are already amongst the “bottom billion” – those poorest of us, all of whom are living on less than $1 a day.  Thank you all for supporting my work here as it is a contribution to the large scale effort which is needed to save lives and alleviate suffering.

Hernando Garzon, MD

Susan Boiko, MD, Upon Departing for Rwanda: If It Isn’t Yellow, Will They Let Me In?

Note:  Susan Boiko, MD, is a Kaiser Permanente dermatologist in San Diego. She is about to leave for Bwiza, Rwanda,  to perform relief work in support of the Pygmy Survival Alliance, a collection of nonprofit organization that connects pygmy villages in Rwanda with information, leadership, survival and health resources to enable them to transform their health and welfare. This is Dr. Boiko’s second mission to Rwanda.

About 50 years ago, for my first Brownie Scout meeting, I needed to bring 15 cents in dues.  My mother gave me a 50-cent piece. Not recognizing it as a valid coin, I cried and carried on so much that the Brownies wouldn’t let me in with counterfeit money, that my mother fished out a crumpled dollar bill that I brought proudly to the meeting.

Flash forward 50 years to San Francisco International Airport on my first leg of my weeklong journey to  a family medicine conference in Rwanda in 2010, where I was to speak on tropical dermatology. It’s 6 a.m. and I’m standing at the check-in counter and I realize I forgot my yellow shot record. Can’t leave to get one at Kaiser Permanente San Francisco. I called my husband in a panic; he calmly suggested printing it out from No business centers open at that hour so paid $50 to use the Admiral’s Club and printed two copies.
Still, doubts plagued me. If it wasn’t on yellow paper and folded into a booklet, would it pass muster at Rwandan customs?

I shared my fears with the flight attendant. Maybe at the next stop, JFK in New York City, there would be a travel medicine clinic and I could get a more official-looking document. The pilot actually radioed ahead- sorry, no travel clinic at JFK.  No time to hop in a cab and find a doctor’s office.  So off I went to Brussels, then Rwanda, a niggling fear that I might be turned away at the airport keeping me from dozing.

Sixteen hours of airtime later, I approached the bored young customs officer in the dimly lit terminal. He glanced up at my face, stamped my passport and said “Welcome to Rwanda.” My Brownie fears melted away. He had not asked for my shot record.

More From Cambodia: Teaching, and Learning

Editor’s note: Nandini Bakshi, MD, is a neurologist at Kaiser Permanente Antioch and Walnut Creek (Calif. ) Medical Centers. She has now returned from Phnom Penh, Cambodia, where she was serving with the Kaiser Global Health Program on behalf of the Sihanouk Hospital Center of Hope in Phnom Penh. This is her second and final dispatch.

Cambodia, Day 12

I have been busy teaching Neurology to the medical students at Preah Kossamak Hospital and the staff (mostly primary care physicians) at Sihanouk Hope Hospital. My routine has been 7:30 – 8 a.m.  rounds/ informal case presentations and teaching at Sihanouk. There are usually about 20 physicians that attend the morning session. Then I head off to Kossamak Hospital to teach medical students – I have covered most of the essential Neurology topics with the medical students in the form of lectures and have managed to cover basic neuroanatomy. Medical students spend 6 years in training after which they do an internship of 1-2 years. The Thursday lecture is especially well attended- one thing they share in common with students and residents in the United States is that free food improves attendance! Thursday lectures have the added attraction of lunch provided by a pharmaceutical drug rep- and so yesterday I had about 100 medical students attend  with standing room only. In the afternoons I go back to Sihanouk Hospital and teach from 1:30 to 3 pm.

In between all this I have had time to read, swim in the afternoons
and relax before I head back home.

Cambodians are very gentle, hospitable people. They are very appreciative of the help they get from Japan and the United States. The hot-button issue in the local news these past few days has been the trial of the Khmer Rouge regime leaders- most of them in their late 70’s. It is hard to imagine that people from such a peaceful culture were capable of such atrocities. I have not visited the
Killing Fields- I spared myself from that tourist “attraction”. Visiting the Tuol Sleng prison and genocide museum was was more than I could stomach. The prison was a school building that was used to torture an estimated 17,000 innocent people including men, women and children from 1975 to 1979.

My overall impression of Cambodian health care is that the country has
a long way to go in order to catch up with the rest of Asia, but the medical professionals are young, hopeful and hard-working.

I have attached some pictures- with the medical students and Dr Hok at
Preah Kossamak and with the local vendors. The girls with the hats said they do attend school – they sell their wares after school and on holidays.

Nandini Bakshi, M.D.
Kaiser Permanente Antioch and Walnut Creek Medical Centers

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