Sustainable Integrated Medicine In Africa

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Dear all,
I just went on my first official mobile clinic, and it went well, to say the least. I realized a day before that I was leaving for the first ever official FIMAFRICA mobile, and tears came to my eyes thinking of everyone that has contributed to this and that finally we've made it this far - thank you, all of you, it`s been a blessing working with you.
It started on 28th January 2009, 7.35am, with the typical sunrise cutting through the cold African morning air. The ride was in the back of a red pickup, packed with me along with a suitcase and bags of repertory, materia medica, morisson's desktop notes, blood pressure cuff and stethoscope, a whole bunch of remedies and my lunch of bananas, apples and a few biscuits - first time, no time to prepare healthy veggies! I felt a bit overloaded in front of the others, since i was catching a ride to save on fuel costs for the foundation. Anyways, they were all supportive and cared a lot for FIMAFRICA`s success. I need to mention the two friends I was with - Morten Kattenhoj from Denmark, who was working for MS Kenya - Morten`s been a great help in introducing me to village chiefs, District officials, nurses, and village workers - Morten worked with the Yaakut people, a tribe whose language is almost becoming extinct (only 9 surviving elders who speak the dialect) since they were merged with the Maasai when the Maasai first came into Kenya - without Morten, we wouldn`t be so far in this project in Laikipia North. Friend number 2 is a recent addition to FIMAFRICA - Graham, a zoologist who is writing new proposals for FIMAFRICA catering towards HIV/AIDS funding.
Cutting across the savannah on the dusty road towards Kuri Kuri, our target village, I noticed impalas grazing in the sunlight, and thought how wonderful it would be for volunteers to come and see this on their way to mobile clinics! Well, it's beginning:).
As we approached Kuri Kuri, I realized what a responsibility we have towards people, their health, especially in the middle of nowhere, it's tough for many of them to go and see other doctors in distant hospitals. We finally arrived to the only building in the entire area - a large school house with empty desks scattered sparsely around the room - I had asked to use this facility in case it rains, although I think it might be fun for FIMAFRICA's volunteers to practice in the open, under a tree or inside a manyatta (Maasai for hut).No one was around, except for a few children playing in the distance - I thought this was going to be a slow day. Richard and Danial, locals of the area, had helped organize this event and had informed the surrounding villages of our coming, and reassured me that people will come once they see us hanging around. So they were right - as soon as the bags had been unpacked, repertory and remedies ready to go, the buzz outside was growing steadily. I looked up and saw numerous heads outside the window - they had all gathered so suddenly without me noticing. I was ready - training at CCNM and on other mobile clinics had prepared me to give myself completely to practicing when the opportunity arose.
First patient, 50+ year old man (age is not accurate in these areas) - walked in, pointed to his tummy and said he felt pain over there. On further questioning, we figured his pain was emaniting from his liver area. I laid him down on the wooden bench, 6 inches across literally, for his physical examination. Just lightly touching the abdomen underneath the right ribs brought enough of a reaction to tell me there was something acutely wrong with his liver. For the sake of completion, I lightly tapped other areas around his abdomen - but the lightest touch even near his liver brought about enough pain to tell me to move on. Further questioning revealed a lot of undigested food in his stools, and sometimes yellow or white stools - a lot of them don`t know their stool colour because they use long drops if not just in the bush. Practicing in these areas leaves no time to do full constitutionals, and the best you can do is address organ systems or acutes. Well, lycopodium, nux-vomica or chelidonium was coming to my mind, when suddenly Daniel told me that this man drinks a lot - I asked to confirm - yes, this man was on everything from local brew (sometimes 90% alcohol), beers and a drug called ``Meraa``, or Khat in English. Well well my friend, we know what to do first. `Yes`, he told me, a doctor long time ago had told me to stop drinking alcohol, but i didn`t listen. Now that two doctors are telling me to stop Meraa and alcohol, I`ll definitely stop. I wasn`t sure whether to believe him, since there`s a lack of commitment to long term health options out here, and drinking is difficult to stop, I`ve seen it many times. Well, I gave him an educational lecture of how the liver removes dirt from the blood, and how alcohol contributes to dirt in the blood and burns the liver - you have to use language that is familiar to experiences in the bush, otherwise you`re just speaking an unspoken language. He seemed pretty convinced, and we let him go. I hope he`s well - I hope to see him next time.
The other patients came in, most bringing children with them and some with tiny 1 month old babies wrapped underneath a cloth fixed across their shoulder. It was nice, and difficult at the same time, treating so many people one after the other, not having the time to do complete homeopathic case. Many of them were too shy to speak up, or were too vague in their descriptions, and some had adults with them, describing their symptoms in ways that doubted your clinical reasoning, because there were two different stories going on. One of the fathers I felt seemed to think that the more symptoms or yesses he said, the sicker the child would appear, so that the medicine would be stronger - at last I found out that the child`s symptoms were from about 4 months ago, and she was already halfway cured. Since there were so many, and we had to leave early at 2pm that day, I asked one of the helpers to examine which ones were the sickest, and bring them in. Itís a pity that we couldnít treat everyone, but over time hopefully more people will get our help!:)
The main cases we saw were chest issues, eye problems, one 1 year old child had blood and puss that oozes out of her ear, another had severely swollen cervical lymph nodes, deviated eyes and no marked swelling in her throat - there's no way to confirm exactly what it is without lab facilities. A couple of children had fainting issues without any specific reasons, accompanied by headache - I've suspected quinine side effects causing this, which happens after they are treated for Malaria - China-sulph homeopathic often cures this. A woman with a swollen goiter came in, treated with Nat-mur!
I've decided to partner with a group that has conventional nurses on their team, and who also service remote areas - I think this will be important in terms of gaining clinical experience for new volunteers and also for me. I`m quite happy with the way it went, but it seems pointless if we're not furthering our clinical knowledge with others and getting feedback from experienced practitioners already in the field.
my dear friends, I'm truly grateful for all your input, inspiration and open help. Come down soon, we'll do this together!
with warm wishes, and lots of love,
Ameet