Fistula Camp - Day One

We finally left around noon – off on the adventure of “restoring women’s dignity” (AMREF’s slogan for fistula camps) and I couldn’t have had a better tour guides for our trip across the country than Dr. Khisa and Richard. It was so nice to see people so proud of their country. We stopped at the lookout point over the Rift Valley, they pointed out every town and every different type of tree. It was a beautiful day for a Sunday afternoon drive. And then we got stopped by the police. They said that Richard was going 112 kph which was “over the spped limit” (there were no speed limits posted on the highway). He talked the ticket/bribe down from KSh 5000 to 200 so it ended up being okay but it was a bit disconcerting to be stopped in the middle of nowhere by “police” that were not above board. We had to buy sugar cane and sweet bananas (plantains) once we got to the Western part of Kenya – the “land of bananas” and very green. The lushness of this area was pointed out to me several times (can you tell my tour guides were biased to their hometowns?) until I said “God must only rain on the Western part of Kenya.” – this amused them immensely.
We got to Kisii around 5pm and the Lonely Planet description did not disappoint:

“Kisii is a noisy, polluted, congested mess and most people quite sensibly roll right on through without even stopping”.
-Lonely Planet, 2008

The one haven was the St. Vincent Catholic Guest House where we were staying. It was not posh but clean and the staff were very friendly. The dorm-type rooms feel like you are in seminary or a monastery with little red flip-flops beside the bed. We had brown ugali that night for diner which I am confident I never need to try again but did try that night for “record purposes” (I did a lot of things for Dr. Khisa for “record purposes”). Ugali is the the maize flour porridge that is the traditional staple food in a number of sub-Saharan African countries (It’s called nsima in Malawi) – it is usually white because all the nutrients have been boiled out of it – the Wonderbread of Africa. But brown ugali I learned was a delicacy that is rarely made correctly but the Catholics in Kisii supposedly have this as their specialty. It’s ugali + kassava + millet (?) and some other ingredients I can’t remember and instead of a thick porridge it has more of a “raw dough” consistency, like thick and sticky peanut butter. Because of this you need to mold it into a ball and swallow it whole (this is according to Dr. Khisa and it’s very difficult sometimes to tell if he is joking but it was what he was doing so I’m going to assume he was serious). After several tablet-sized swallows I honestly count not swallow my dinner any longer – that was the end of the love affair between me and brown ugali.
I met the rest of the fistula team that night – they were lovely and extremely gracious. There were two other gynecologists – the host from Kisii and one from Kisumu , an anesthetist Dr. Okumu, who I believe is the best anesthetist I’ve ever met and one of the nicest guys, Rachel and Kristin (two Nairobi nurses who had also been there the week before) and Agnes from Human Rights Watch who came to talk to the patients about their experiences.In total at the camp there were 42 patients that had been screened as good candidates and would be operated on in this two-week camp. The simple ones had been done the week before by the two other OB/GYNs and the 18 more difficult cases remaining were for us that week. To put this in perspective for those not usually finding themselves in an operating room, a typical OR slate in Canada usually has a maximum of 3 major case a day (usually) and we were going to double that. We enjoyed the luxury of a good night’s rest before what was to come.