Fri July 29. Evening time. We are mostly outside. One of the MPH students is playing air hockey on an ipad with 2 of our interpreters. They are delightful young men about 25 years old and will help us with anything.

Profiles of the Poorest

Today David and I walked about 4 miles around to 2 different very poor households. One woman was widowed and is trying to raise her 3 children by herself. Her home is about 8 x 8 feet. She cooks outside over wood. She has 3 chickens but no garden. Then we went to another home with an old grandma, who is 77. She barely gets around with a stick because she has such bad arthritis. They need everything, food, bedding, clothes and school fees for the kids. I came back covered in red dirtI came back covered in red dirt.

We  went to the river where people get water. They dig a hole in the dry sand at a bend in the  the riverbed. If they dig deep enough (sometimes 10′ down), water seeps into the bottom of the hole. People patiently scoop water off the bottom of the hole, filling a bucket, pouring each small bucket into larger ones tied to a donkey. The donkey can carry four 20 liter cans and he may have to walk several miles to get the water home.

The land is very dry and dusty. There are aloe plants and other cactus. The plant that makes the fiber the women weave into baskets looks like the century plants we have in Albuquerque. Mango trees are the only lush tree in sight. They are beautiful bright green and tall.

Today’s Clinical Impressions

I (Rifka) worked in the clinic in the afternoon. I did get to see a few very healthy babies. It was great to reassure the moms that they were doing a good job and just had to keep breastfeeding their babies. One of the moms had started supplementing her 4 month old with goat’s milk and the baby had a little diarrhea. I explained how important it was not to give anything but breast milk for 6 months. Later, I saw a 32 year old man who had lost a lot of weight and had a large growth in his upper abdomen. We are taking him to the nearby town of Machakos for more testing.

Every day I have a better sense of what are common complaints, what tests and and what medications I can prescribe, but everyday there is something very difficult and challenging that I have not seen before, or I feel I can not do much  help.

Cloudy days mean little power

It is peaceful here and when the sun is out we can see rolling hills for miles. It has been very cloudy and it is interfering with our ability to communicate because we can’t charge the solar batteries enough to keep our computers running and our internet connections are so slow.