Pathology volunteering (and playing) in Kijabe kenya : 3rd week, work and Hell's Gate

Ending our 3rd week. Work has continued semi busy, or at least the afternoons. Mornings are not so bad. This wednesday we grossed at least 60 cases... learning to be efficient!

Typical walk out of Lab into hallway. Can't really communicate here the various smells and sounds...

A few of the specimens for the day.

Promise won't put photos of many yucky specimens, but this mass came from a 2 year old. She had it since she was a baby. It weighed 2 kg (about 4.5 lbs.). We have a photo of the girl, but it is too horrible to post.

For those interested - malignant germ cell neoplasm, focal yolk sac but mostly undifferentiated/immature teratoma.

Brain with TB. I think we all need to get TB tests when we get back home (we get at least one case a day). Though Mom is already positive so I guess there is no point for her.

We've gotten into an AM routine. Up at 4:30 (Fri slept until 4:40), fiddle around on computer, do yoga, then off for a run. Beautiful days lately! No clouds and sunny with no breeze. Avoiding going downhill the run heads up pothill filled pavement, then meanders up rutted dirt/mud road until road peter's out into a path.

Baboon along jog; too busy eating to join in I guess.

First turn around spot is at the end of about a foot wide path on the side of the green/jungly hill. There's a little hut at the end of the path.

Fri AM as I was photographing (and listening to music), I heard a "good morning, good morning". There a middle aged quite plump african woman in skirt and multiple shirts stood outside the hovel. She invited me in to say hi. She might be one of the women who works at the market but I'm non entirely sure. She showed me into the doorway of her 1 room hut which she shares with her just graduated daughter and young son (still asleep on one of the bunkbeds); no running water, no electricty, laundry hanging from a clothesline slung from one wall to the other; minimal ambient light from the window (so couldn't photograh). She (Joyce?) cheerily chatted for bit, introduced me to her daughter Eunice (lookig for work, but up and dressed at 6:50 AM) and said I must come back for a visit. How to people stay so cheery in those circumstances?? On the way there I was feeling homesick and somewhat wondering what I am doing here. On leaving, near tears, felt at least I am doing what I can to help these people.

Work cases have included far advanced breast cancer (there is not screening here, but of course evidence that screening does any good is essentially not existent), the usual esophageal cancers, multiple myeloma, central neurocytoma, rhinosporidiosis, thyroid cancer, stomach cancer testicular cancer, TB in the brain and bone, fibrous dysplasia, ossifying fibroma.... the list goes on and on. Everyday there are cases we wish we could do special stains on, but we do the best with what we have.

Clinician oncologist here for 2 months is about to leave. He is the only oncologist here. He is pretty burned out. Frustrated with lack of chemotherapeutic agents, frustrated with lack of blood support, frustrated with inability to help more then he/they can. I know the people here really appreciate what we do, but they need so much more then we can provide.

There is no volunteer pathologist scheduled for feb or march.... hopefully they can higher a part time recent graduate from Nairobi. Wish I/we could stay, but will also be ready to head home.

Luckily we got a respite from work on Sat. Left at 9:00 AM for Hell's gate. Video is of drive there. with Philip speaking Swahili in the background.

Hike was great. Warm bordering on hot. Little Masai boy joined us and helped along the way taking photos which he enjoyed tremendously. Everyone were troupers going over/up/down rocks etc.