Health

This past week I have spent most of my time with Silivia, as she attends her many patients. Her clinic is a small room, with a dirt floor and drugs that sit on newspaper lined shelves. She specializes in tooth extractions - doing anywhere from 5 and up a day. People travel far and wide to come to her. They sit in a plastic chair as she explains the procedure before injecting to numb.

A fisherman from the lake sits across from me, his cell phone dangling from his neck with fishline. He tells us he caught a nile perch that was 13 kg, motioning from his toes to his upper torso. I ask him how he catches such a large fish while we wait for his gums to numb. Silivia tells me everyone numbs in different amounts of time - with drunk people numbing the fastest. The extraction is done in about five minutes. I place pills in a small brown envelope as Silivia instructs him not to eat for hours. He walks out and climbs on a piki piki taking him back to the lake.

An old man hobbles into the clinic with the help of a carved wooden cane. He tells Silivia he is having tooth pain - although I can only see one hanging tooth in the center of his mouth. She looks at me laughing, explaining that she has to remove 3 of his teeth for only 100 shillings. She is done faster than the last time. The man pulls out a small matchbox, removing his carefully folded money and handing it to her. He takes the pills I hand him and places them in an out of sight pocket, removing plastic wrappers as he brings his hand back out. Silivia sends him back to his home, his mouth full of white cotton, to bring her maize to make up the difference in payment.

One of my favorite old ladies comes to Silivia and I as we walk back to the house. She complains of not being able to sleep, of feeling sick. I walk to the house to get her malaria drugs and aspirin from the container Silivia keeps in her cupboard. We take her a plate of leftover nile perch later - sitting with her while she eats it and asks us the time. Silivia calls her son, and gives the phone to her to talk to him. She yells hello loudly, looking disoriented and quite confused.

We spread a pile of soil into raised beds in the garden later in the afternoon, while I talk to Silivia about how she is able to reach people so well in this community. She does not wear a nurse's uniform, there are no registration fees or receptionists. I comment out loud that I think she is serving people better without having a clinic and system set up - that people know they won't be turned away because they don't have money, and that she will speak to them in a language they understand. I wonder to myself if this will still be possible when she has her clinic someday - if she'll be able to reach as many people as she is now, if she will still find the time to dig in the garden and make house visits to lonely old ladies. Is it possible that the people in this community are healthier without an institution in place? Will that change when her dream clinic/hospital will be built? Will she be able to find other medical practitioners that reach everyone like she does? And if not - how will that effect the health of this community?

Sunrise

I wake up at 625 to my beeping phone alarm. I am disoriented, trying to remember where I am as my blurry eyes adjust to the darkness. I throw my legs over my bunk bed and mentally wrestling about getting out from under my warm blanket, pulling my mosquito net up around my shoulders, searching for my running shoes. I dress in my dark room with the aid of the flashlight on the end of my phone

I step outside, hugging my shoulders from the cold and looking around. The sky is a faint blue, the moon fading. Birds are the only sounds you can hear. I beginning running towards the bridge that spans across a brown river where everyone collects their water from during the dry period, pushing my tired body to take step after step. My feet thwack the red, packed dirt road, my lungs begging me to stop. I think of running on the indoor track at Western's gym, with my ipod and water handy.

I pass ladies with baskets of clothes on their head walking to the lake to do laundry. We exchange greetings, and continue on our respective paths. I move for bicycles that are tied down with plastic jerry cans for water, calling hello after they rattle and clink past me. Children giggle as they pass me in twos and threes on their way to school. Wisps of smoke hover over pots cooking over fire. The sky is streaked with pink and the morning is so fresh and damp that I can taste it in my mouth. Two geese fly over my head, honking.

This is quickly becoming my favorite time of day here. We have officially entered into the dry period, and it starts to get hot by 8 in the morning, becoming unbearable by about noon. The ground is so dry that large cracks are everywhere – as if they are begging for even a drop of water. Cholera has become rampant because people don’t boil the water they walk distances to get from the river.