lunedì 15 giugno 2015

My experience in Cottolengo Mission Hospital Chaaria

I remember one evening when I was having dinner with younger colleagues in Meru during a KMA meeting, one of the colleagues causally said 'The doctors in Chaaria are quacks.' 
I was so hurt and shaking from head to toe in anger . 
I took it so personally and gave him a piece of my mind. I almost shed a tear, I didn't know that I had come to own Chaaria that much. I asked him to go ahead and give me ten reasons why he had generalized Chaaria to be a substandard hospital; he couldn't point on any single reason despite thinking hard. 
My final conclusion is that he had inherited that ideology from his seniors. He had never been to Chaaria, couldn't point at any single patient we had mismanaged yet he had gotten used to the ideology that Chaaria must be substandard because the prices are too cheap. 
I feel very sorry for the doctors who have refused to change this school of thought. Instead of doing blame games, we would be of much help to the citizenry by having collaborations, consultations and referrals among one another.

My boss Dr. Gaido always tells me that our 'Big-Brother' is our patients. They still come despite discouragements from medics in town.
They came from as far as Mandera and still spread word for the good job we do.

The first day I took Chaaria seriously was during a KMA meeting when Dr. Gaido announced that he was looking for M.Os to apply for locum chances. I had just finished my internship and I was actually broke due to new investment commitments I had embarked on. Any chance to make an extra coin was a welcome idea. 
People warned me that Chaaria was in the middle of nowhere and that no sane lady would make it to locum there. I decided to visit the hospital and keep an open mind. I remember it was a Wednesday afternoon when I made the trip, I found the OPD so full of patients and told myself that if so many patients could make it here while frail and sick then I could also make it for work. 
The first person I talked to was Senior Clinical-Officer Jonah Gitobu Mworia, I introduced myself and he was very helpful. He showed me a place to sit and asked me to sit and wait for the 'boss'. Dr. Gaido saw me a few minutes later and told me the he instantly trusted me due to my religion and believed that I would not let him down. 
As planned, I was able to work in the days agreed upon and it wasn't bad at all. While my colleagues back in Meru still complained that it wasn't humanely possible to commute to Chaaria, I was busy making an extra coin and learning a lot at the same time.
When I applied for my annual leave at Meru Hospital, I knew 45 days was a long time to sit at home and do nothing. I was also tired of working in an environment where systems where just not running. 
Thanks to the county health administration, things at Meru Hospital are much better now. So anyway, despite having an opening at Agakhan Meru, I approached Dr. Gaido and asked him if he could give me a 45 days locum opportunity. 
He gave it to me without blinking, it was such a relief; I would clear one of my many small loans at a go with the locum income and at the same time learn a lot. During the course of the locum, I came to really love working in Chaaria. I felt that I belonged there.
The satisfaction of helping a very poor patient get 1st class health service at a near zero cost was immense. I did the unimaginable among young doctors and decided to apply for a long-term secondment opportunity. Many people called and discouraged me, I was going to get cut off from civilization , that's what they told me. 8 months later, I'm so glad I took the plunge. I'm definitely not the same Khadija. 
My life has changed, I have gotten so much experience, I have gotten so exposed by working with professionals from Italy, Poland,Britain, Canada etc.
Chaaria is the only mission hospital in Meru that never turns away anyone because they cannot afford admission fees. Service to the poor is really the mission here. We have done major surgeries for patients knowing very well that they wouldn't afford the bear minimal of the cost but we have done what we have to do to save their lives.
I remember one instance, my friend from Meru brought his sister to have a kidney stone removed. The minimal cost he had been charged in Nairobi was 500,000 shillings. 
I called him and told him that he would pay nothing if he had a NHIF cover. He couldn't believe it. He asked me a few questions just to clarify if it was standard surgery. 
I reassured him. Because his patient was not covered by NHIF, he paid a total cost of KShs. 6,500 and surgery was successful. Since then he has been a good ambassador to us. 
He is one man that shuts down those that call us substandard because we are too cheap. Kenyans must change that ideology that cheap is fake. If an organization wants to help,
don't start doubting it for being too cheap. 
Another thing is that our buildings are not as posh, but would you rather be in a posh building and get substandard yet costly service or be in a standard simple room and get 1st class service at a low cost???? Food for thought.
When I asked Dr. Gaido to teach me how to do Hysterectomies, I was scared, I didn't know what to expect. I had been in a system where no one would dare teach you something major for fear of you bringing competition in the private sector. 
He was very happy with my new interest and taught me very selflessly and patiently. I'll forever be very grateful to him.
One of my patients told me that in his opinion, Chaaria was the prime Cancer Diagnostic Centre in Meru and that I should look for Hon. Julio Mbijiwe and show him our cancer registry and challenge him to ask the County Government to facilitate a monthly visit by an oncologist at Chaaria. 
I was touched by this view. The patient had visited the Oncology clinic at Meru Hospital and had noted that 98% of the patients there were referrals from Chaaria with referral-letters written by me. So instead of sending the patients there, why not send the doctors to the patients? I hope Hon. Mbijiwe sees this post and does something about this situation. 
We are the only hospital in Meru doing ultrasound guided biopsies and having an organized histopathology chain.
The road to Chaaria is terrible, totally impassable during the rains.
If Chaaria sees a net of 150 patients per day despite the bad road, can you imagine how many more patients we would help if the road was tarmacked. I implore the County Government to take the example of Machakos County and prioritize infrastructure especially if it also opens up a health facility. Hon. Munya are you listening? It just takes three months to tarmack a road 'Mutua-style.'
I could write and write, but Cottolengo Mission Hospital Chaaria has changed my life in so many ways and I'm very grateful for the opportunity to work here. I don't take it for granted. My ideologies have changed, I have become more tolerant and patient, but above all, I have become a better clinician with so much experience that my colleagues can only envy.

Dr Khadija Mbeneka Ali

Nessun commento:

Chaaria è un sogno da realizzare giorno per giorno.

Un luogo in cui vorrei che tutti i poveri e gli ammalati venissero accolti e curati.

Vorrei poter fare di più per questa gente, che non ha nulla e soffre per malattie facilmente curabili, se solo ci fossero i mezzi.

Vorrei smetterla di dire “vai altrove, perché non possiamo curarti”.

Anche perché andare altrove, qui, vuol dire aggiungere altra fatica, altro sudore, altro dolore, per uomini, donne e bambini che hanno già camminato per giorni interi.

E poi, andare dove?

Gli ospedali pubblici hanno poche medicine, quelli privati sono troppo costosi.

Ecco perché penso, ostinatamente, che il nostro ospedale sia un segno di speranza per questa gente. Non ci sarà tutto, ma facciamo il possibile. Anzi, l’impossibile.

Quello che mi muove, che ci muove, è la carità verso l’altro, verso tutti. Nessuno escluso.

Gesù ci ha detto di essere presenti nel più piccolo e nel più diseredato.

Questo è quello che facciamo, ogni giorno.

Fratel Beppe Gaido

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