Category Archives: Kenya

From a Clinic in Kenya, OB-GYN Deb Matityahu, MD, Shares One Young Woman’s Journey

Dr. Deb Matityahu, OB-GYN and Chief of Service for Kaiser Permanente in Redwood City, has returned to Eldoret, Kenya. She volunteers at the Gynocare Fistula Centre, a clinic dedicated to repairing gynecologic fistulae, which arise when a pregnant woman’s delivery stalls. Tissues are damaged when the baby dies and must be removed from the womb. Dr. Matityahu and her teenage daughter started a non-profit, “A Little 4 A Lot,” which works to rehabilitate the often poor and shunned women after their repair. ALittle4ALot.com has raised money to provide sewing machines and lessons for the women. Here is one of their stories:

Ann  is one of our patients.  She lived in a poor village, and had to drop out of school. She was sent to Nairobi to be a maid. While in Nairobi, she was dating a boy for just over one year and became pregnant.

At first, Ann didn’t know she was pregnant; she just thought she was sick.  When she found out, Ann returned home to her village and  went to the hospital.  When she delivered in the local hospital, she had a large tear through the rectum that was not repaired well.  This resulted in a recto-vaginal fistula (RVF). For those of you not familiar with RVF, it is a tear from the rectum to the vagina, resulting in stool leakage through the vagina.  Not pleasant, as you can imagine (understatement).

Because of the stool leakage, she was reluctant to eat or drink anything if she was out of the house.  She was embarrassed, ostracized, and depressed.  She lived with the fistula for three years before learning she could come to Gynocare (Fistula Centre in Eldoret)  for repair.  She was repaired in 2011.

Ann was tearful and crying through most of her story.  She recently finished her dressmaking class, and says that learning to sew has changed her life.  If it weren’t for us and for her sewing machine, she would be working in someone’s home again for 800 kes a month (the equivalent of $10 US).  Now, she knows she has a skill and has value.

Ann believes she will be able to return home to give her 5-year-old daughter a better life and an education.  On the sewing room wall behind her were about six tote bags that she has already sewn.   I plan to purchase them all and sell them in the states.

She continues to cry, insisting that we have changed her life and cannot thank us enough.  At this point, I am crying too and got up to hug her.  I don’t think I fully realized what we have started with this program, and what we have already accomplished in such a short time.

Dr. Deb.
Eldoret, Kenya

RWCDrMatityahu-L-Pt-ClinicDirector-R 2012

In this 2012 photo, Dr. Debra Matityahu poses for the camera with a fellow doctor and patient in a clinic in Kenya.

Hernando Garzon Blogs From Kenya: Five Minutes, Five Images, from the Kibera Slum

September 6, 2011

I have 5 minutes for an update!

My planned trip to Somalia was first delayed, and now canceled, as there has been an escalation of fighting in the Galcayo area, and we’ve reports that up to 50 percent of the population is fleeing.  We’ve evacuated the two non-Somali staff to a safer location.  Review of that program will unfortunately have to be from a distance.  We still have national staff working in that program, and are extending into other areas of Somalia.  The existing program in Galcayo has seen more than 15,000 patients and immunized close to 2,000 children.

In Kenya, we are still developing two areas of possible involvement.  In a few minutes I’m off to the pastoral district of Mwingi to assess needs for health and nutrition support there.  We are also still looking at opportunities to get involved in urban ares – the slums in Nairobi, and the doubling/tripling of food prices has many families down to one meal a day and malnutrition rates climbing.

The attached are photos from an assessment of the Kibera slum, the largest in Kenya.  I believe the greater good would be served if everyone from a developed country had the opportunity to spend such a day in Kibera – just to see firsthand how others have to live.

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More later.  Peace,

Hernando

Hernando Garzon, MD, in Nairobi: Shocking Conditions in an Urban Slum

Sept. 1, 2011

All,

I worked in the Mathere slum in Nairobi for a month after post-election violence in 2008, and visited again in 2009 (when working in western Kenya). One would think that after such time here, I would be “used to it.” It is, however, still shocking to see the conditions under which our fellow humans live.

While so much of the media coverage of this Horn of Africa drought/famine shows malnutrition and famine in Somalia and the refugee camps in eastern Kenya and Ethiopia, it’s clear that there are other areas in both Ethiopia and Kenya which are also affected by drought and malnutrition.  What is also not well reported is that malnutrition rates in the slums in urban areas are also increasing — food is available, but people cannot afford the higher food prices. Rural malnutrition rates of 10-15 percent may sound worse than urban malnutrition rates of 2-3 percent, but consider this: That malnutrition rate of 15 percent in the rural areas may represent 3,000 children, but the urban rate of 3 percent may represent 12-15,000 children.  Because of this, we are also evaluating the needs of urban slum environments, and this is what prompted today’s visit, and the attached photos.

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Perhaps my most surreal experience of the day happened while walking through Mathere, when I saw a young man I had taken care of during the post-election violence here in 2008.  I recognized him first because of his amputated right arm, which he lost as a result of a traumatic machete attack 3 years ago. In contrast to the look of fear and terror which I remember so well in his face, and which was so common in all our patients here 3 years ago, he had a smile, looked at ease, and looked healthy. It was wonderful to speak with him, and amazingly heart-warming to see such a positive outcome.  Those few minutes reminded me how the efforts made to work in these environments is so worth while.

In other news, Relief International is proceeding with expanding the existing nutrition and health program in Galkayo, Somalia.  The plan is to develop a Maternal/Child Health program and a malnutrition program in Matabaan, a town about 70 miles south from Galkayo, in central Somalia.  While not visiting this site, I am helping to organize that program.

Thank you for reading.

Hernando Garzon, MD
Kaiser Permanente Sacramento Medical Center

Dr. Sarah Beekley’s Work in Kenya – With Her Three Daughters

Note: Sarah Beekley, MD, a pediatrician at Kaiser Permanente Redwood City (Calif.) Medical Center, volunteered late in 2010 at a clinic in Matibabu,  Kenya. The clinic is endorsed by The Permanente Medical Group. While many TPMG physicians have volunteered at the clinic, Dr. Beekley brought along her three adult daughters — Anjali Joseph,  Jenna Hahn,  and Lauren Joseph — who volunteered in the village while Dr. Beekley worked at the clinic.

The Matibabu clinic provides medical and community health services to rural families in one of Kenya’s poorest regions.  Though a tight-knit and resourceful community, the children suffer from the lack of clean water, poor nutrition, and a high rate of communicable diseases.  A large number have been orphaned by HIV. Most have to leave school before their teens. Nearly every child brought to the clinic with fever had malaria and many had secondary infections or profound anemia.

Each of the three Matibabu doctors sees 50-plus patients a day, and I had to work hard to keep up.  I quickly learned the basics of tropical medicine and the limits of working without sophisticated equipment. The clinic is fortunate to have some basic diagnostic equipment, health educators, and a small pharmacy on site.  Despite this, there were the daily frustrations of working without the equipment that I routinely took for granted at home, such as a head CT for the young boy with a probable brain tumor, or a cardiac echo for the young girl in congestive heart failure.   Tests are not cures,  however, and regardless, these families had no resources for treatment.

My greatest, and unexpected, reward was watching how enthusiastically my daughters adapted to the new culture, and how creative and resourceful they were in contributing to Matibabu’s work. Jenna and Lauren put together a plan for a children’s center designed to attract young families and designed the content for a year of educational events. One of these events was modeled after Kaiser Permanente’s own educational Teddy Bear Clinics. They also translated information on sanitation and hygiene from English into the local language of Luo. They then distributed soap and educational material and performed demonstrations to both small and large gatherings in the community. Anjali worked at the Youth Center, continuing the work of a previous volunteer who had inspired a group of teens to write and perform a peer-to-peer play dealing with alcohol and substance abuse. She also took the initiative to design a handbag using the beautiful batik fabrics of East Africa. The three girls then kept the majority of seamstresses in Ukwala and at Matibabu’s vocational training program “Stitches for Change” busy sewing these bags.

My daughters, and the Kenyan youth they worked with, reminded me not to underestimate the ability of young people. Rather, my task now is to help find new challenges for them!

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