Mobile Clinic
From its very inception in 1987 to the present date, SHARE has always had as one of its purposes the delivery of health care to the isolated and impoverished rural areas of western Kenya. For several years we sent our doctors on mobile clinics there whenever and wherever we could, while we pushed forward our plans for all-year-round clinics.
The Setting
But what does doing a mobile clinic really involve? What is it actually like to go on one? Here is what happens on a typical trip to one of the islands on Lake Victoria. This particular island is called Remba. It is one of the fishing islands in Lake Victoria and one that is so distant from the mainland as to be completely isolated from direct mainland contact. The people who populate the island are mostly fishermen and their families; they often migrate from island to island, always looking for the best fishing conditions.On the island of Remba, there is no electricity, no running water (Lake Victoria itself is fresh water, but it is infested with snails that transmit schistosomiasis, a parasitic disease, and is not a healthy source of water), no medical facilities whatever. The people who live there live on fish and on a few vegetables they grow from the small patches of arable land that they are able to farm.The fish catch is their cash crop, and it pays for the rest of their livelihood.
Mobile Clinic
From Dawn to Dusk
Our day began at 5:30 A.M., when we were awakened by the screaming of an alarm clock; because of rough conditions on Lake Victoria every afternoon, it was necessary to boat out early to the island and boat back before 4:00 P.M. We had packed our carry-alls of medical supplies the night before, and after a hurried breakfast we drove to Father Tielen’s dock (Father Tielen is the local Catholic priest who owns and runs the best boat on Lake Victoria—a 45-foot, all-steel, diesel-engined boat that could probably withstand a hurricane!) and boarded the Nyasaye Erokamano(in English: ‘Thanks Be To God’). We spent a wonderful three hours motoring out to our island (the longest mobile clinic we have ever been on); dark volcanic cones projected up from the surface of the lake all around us, many of them had small strings of huts running along the water’s edge; strange and lovely birds could be seen, and a few vultures, too!
Mobile Clinic
When we arrived we found no docking facilities at all, so we had to load ourselves and all our baggage into our own dinghy and make several trips to the beach, where the Kenyans happily helped carry it all to one of their small mud huts. We set up our clinic in a room with a few tables (one for each doctor, one for the nurse-pharmacist, and one for our nurse-clerk- interpreter), a few chairs and a bench or two. Most of the patients had to stand in line outside the hut. For three hours we labored mightily, trying to diagnose without any laboratory tests, trying to stretch our limited medical supplies to fit their needs, washing our hands so as to use for this purpose as little as possible of the precious water we had brought, trying unsuccessfully to see all the patients who wanted to be seen. We paused only to drink sodas donated by the island people.
Every patient had scabies (a parasitic skin infection), most had chronic recurrent malaria, and many had schistosomiasis. We saw no children or adults with diabetes or heart diseases; they simply do not survive. Much to our surprise and pleasure, we saw only a rare child with severe malnutrition; the fish and vegetable diet seemed not too bad. Totally exhausted, we piled ourselves back into the dinghy, back to our boat, back to our base on the mainland