Wednesday, March 09, 2005

Mud Hut Pharmacy

When Kenyans learn I'm from the U.S., they begin to ask about the weather, how it compares to Kisumu, and the cars, 'how much would that white car cost?' they ask as they point. And they all want to know the cost of air fare from Kenya to the U.S. Street children ask me to take them to the U.S. and grown men want to know if we have lions and cows and giraffes as they do in Kenya. And what about these secondhand clothes, one man asks, do people sterilize them before they're sent to us?

The U.S. is the land of milk and honey to Africans. I now know why, after seeing the poverty, and especially when one shop owner asks me if people in the U.S. are as poor as the people in Kenya. I had somehow managed to avoid thinking about the disparity. Not even close, is my answer when I'm forced to think about it. Everyone in the U.S. has access to health care and emergency medical care, even if they can't afford it. They at least have somewhere to go in the middle of the night and usually have means for transport. In Kenya, most rural people have no money to pay for healthcare and they can't even afford the cost of a ride.

TICH works with rural communities to provide medicine, training local women as Community Health Workers (CHWs) to dispense the medicine to their neighbors in the middle of the night, or whenever necessary. These women work in the community pharmacy as volunteers and farm for a living. I was at the community pharmacy in Abom, Bondo District, this week. It was an hour and a half drive out of Kisumu. The pharmacy, a round mud house with a thatched roof, sits under a huge Mango tree. It's incredibly neat inside, and cool compared to the heat of the sun outside. All day, chickens and chicks walk into the room, peck around, then tumble over themselves out into the yard. The walls are covered with flip chart pages showing the community's animal and farming projects, their objectives, goals and results. There are graphs and photographs, everything you'd expect to see in the boardroom of a major U.S. corporation. Except for the little chicks pecking at your feet occasionally.

Phelesia, Janet and Prisca are the three trained HCWs for their area. Phelesia looks old and has eight children. She's a Traditional Birth Attendant; what most people simply call a mid-wife. She's delivered 20 babies in her neighborhood in the last seven years. These woman are bright and energetic, bringing us tea and tiny bananas for tea. Alice, a TICH co-worker, refuses to drink tea until they bring cups for themselves. She translates into Luo and English so we can share stories.

One flip chart shows a list of the most common illnesses for the people of Abom: Malaria, diahrrhea, cough, common cold, headache, fever, rashes, backaches, worms, wounds, scabbies, measles, stomachaches, cholera, swelling body, typhoid, asthma, ulcers, amoeba, T.B., Virus (HIV).

When I ask if they discuss birth control with their neighbors, especially the 16-year-old girls who have just given birth, they giggle. Yes, they can discuss these things with the women, but it is still the man 'who wears the pants in the family.' He decides if they'll use birth control and if they'll have more children. Amazing that Prisca was able to stop after her third child. Maybe she'll be a role model to women in her community as she dispenses drugs from the round mud hut under the Mango tree.

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