Mobile Clinic Days

All stories are shared with the permission of the patients’ families; even so, all the children’s names have been changed for privacy.

Two mobile clinics were photographed for this day, and have been combined into one for the sake of the post.

BethanyKids has over 15 locations in Kenya where it holds mobile clinics, and each location gets visited a few times a year. These clinics are where children come for follow-up care after they have been treated at the BethanyKids wing of Kijabe Hospital. The mobile clinic team has nurses, a therapist or two, a social worker, and a parent to parent mentor (a parent who has a child with special needs who helps provide support for other parents facing the same challenges). Luke goes on the one-day mobile clinic trips whenever he can, usually 2-3 times a month. I went with him on two recent trips and I hope you enjoy my impressions.

The day starts early – sometimes departure is at 5 AM. Luke drives our matatu around the Kijabe area, picking up the team in the early morning light.

Heading towards the direction of Nairobi on the recently redone highway. Views of the Great Rift Valley that our camera could not capture.

Construction ahead, but no cones to warn you. Just squeeze around.

Passing towns with vendors’ stalls lined along the roads.

Driving out the other side of Nairobi, through savannah and hills.

Luke, our intrepid driver.

The team in our matatu, surrounded by wheelchairs and equipment. Some were clearly having a bad hair day and did not want to be photographed 🙂

On one-day clinics, the team arrives at the clinic site after 2-5 hours of travel. The waiting rooms are already packed with patients and parents, lined up and waiting.

Here’s the waiting room half full, after the clinic had been going on for several hours.

First stop for everyone is registration. I pulled the patient’s chart, transferred information onto a new form Luke designed, and verified the information with the parents. I spoke mostly English, but did my best to find the Swahili words I needed. Julia, the team’s parent to parent mentor, helped me a lot. She encourages them to join a support group if they haven’t already, and offers some advice as needed.

From there, the parents take their child to see one of the nurses. After a check-up, the nurses determine if the family should see the social worker and/or the therapists. Almost everyone goes to see the therapists.

After most of the patients were registered, I went back to see Luke at work. Jenner has hydrocephalus and spina bifida. She had shunt surgery and a spinal closure at BethanyKids at Kijabe Hospital. As you can see, she’s doing great now and is a happy and friendly little girl. Luke did an assessment on her and gave the parents exercises to help her walk better. She had not been able to participate in school activities because of some walking challenges, despite the fact that she is one of the small percentage of children with spina bifida that is able to walk without assistive devices.

Luke fits all the wheelchairs he can into our car for each clinic. This is Brian getting fitted for his first wheelchair. His dad intently looks on, learning all he can about the parts of the new chair. Brian’s new wheelchair will not only allow Brian to attend school for the first time, but will also allow his father to find a job because he will not have to worry about staying home with Brian during the day.

Some kids aren’t too sure about this whole therapy thing. This little guy cried and cried, so Luke took the time out to give him a paper to hold and to play with him a little before continuing.

He still wasn’t so sure, but he calmed down enough for Luke to measure him for some new AFOs (ankle foot orthotics) and to apply some kinesio tape to his legs. Thank you to those who have sent us kinesio tape! Luke uses it all the time.

Fifteen year old Susan was born with spina bifida, and has never had her own wheelchair. Her mother carries her tied to her back with a cloth. Susan was really happy to try this chair out – a big step towards greater independence and growth.

Vivian is a 18 month old girl with hydrocephalus. She had shunt placement surgery at Kijabe Hospital as well. Luke does an assessment on her control of her limbs as her very caring mother looks on. Mom is also trained on home exercises, as she has no other source of therapy outside of the visits she gets at the mobile clinic 4 times a year.

Vivian is very intelligent. She babbled to her mother throughout therapy – she knew many words. She kept an eye on Luke and interacted as much as she could with her hands.

The difficulty that Vivian is having is that her head is too large for her to hold up on her own. Her neck muscles cannot get strong enough at her age to hold it up. Luke suggested some exercises for mom to do with her that will begin to strengthen these muscles for when she is older. Luke hopes to find a suitable wheelchair for this little one so that she can more fully interact with the world around her.

After the last patient of 50 to 100 patients has been seen, after working 8 hours with no break for lunch, the dedicated mobile clinic team gathers to share some chai and chapatis (kind of like tortillas). From the left: Mama Leo, a SHAK (Spina bifida and Hydrocephalus Association of Kenya) representative, James the OT, Leo (of Mama Leo, who was visiting from his school in the area), Daniel the nurse, Jane the head nurse, Jane’s daughter the volunteer, Esther the nurse, Julia the parent to parent mentor, and Miseyoka the social worker (just his hands showing). What a wonderful, hard-working team they are.

The big Catholic cathedral where the clinic was held has finally emptied out. (Interesting fact: Pope John Paul II laid the cornerstone here.)

Leaving the goats to mow the churchyard in the city, the equipment is packed up, and the mobile team starts the journey back to Kijabe and home. They will do it all over again, at another site, in two days.

But some things stick with you. Little babies with twisted limbs and swollen heads and brain damage, coming by the dozens at every site. Parents hopeful and depressed, determined and apathetic. Christians and those of other religions not mentionable on a public blog or no religion at all. All of them made in God’s image and loved by Him. All of them worthwhile and worthy of love. May the mobile clinic team continue to ease suffering and soften hardened hearts, allowing God’s love to seep in.