Out of Africa: Lessons on being a nurse

Children playing in Africa
Children playing in Africa

Imagine seeing all the amazing colors of Earth in one place. Visualize vivid green grass in the morning that turns to a profound deep green in the early evening before sunset, and shades of brown and beige with hues of orange throughout on the horizon. In addition to the breathtaking landscape, seeing countless zebras with finely detailed black and white stripes and giraffes with shades of brown and white spots, all within the eye's view. This was not a ride in Disneyland but a ride in a large van carrying nurses, physicians, and ancillary staff to a small village outside Nairobi, Kenya. Here, I share with you the beginning of my nursing work in Africa.

The Maywood [New Jersey] Rotary Club sponsors an elementary school in a small village in Kenya, providing items such as school supplies, uniforms, and daily lunches. Bigger projects included building new classrooms, installing fences around the school buildings to protect the children and staff from wild animals, and constructing a mile-long pipeline from an underground spring to the school that delivers fresh, clean water to the children and surrounding community.

As to be expected, I was both nervous and excited about the mission trip. One of the hardest parts was the grueling travel; it causes pure exhaustion. The trip to Kenya begins with two very long flights—New York to Dubai, United Arab Emirates, and then onto Nairobi, its capital city.

Nairobi can be compared to New York City, albeit a severely impoverished version. Diesel is the only fuel, and the exhaust causes thick air congestion. There are no traffic lights and only a few stop signs that appear to be ignored. I was amazed there were not more accidents.

After our team arrived at Nairobi airport, we climbed into a van that took us to the campsite—a 4-hour ride over unpaved roads. Once out of the city, we saw some residential sections with beautiful homes. These homes were in gated communities due to the high crime rate in Nairobi. After passing these sections, all that was visible were the spectacular African Plains.

After traveling for 2 hours, the van pulled over so we could view the Great African Rift, a grand valley whose beauty could not be captured with a camera. Surrounded by mountains on all sides, words cannot fully describe its magnificent beauty.

I will never forget my first experience with the children in the village. The number of children in the pre-K and kindergarten class overwhelmed me; more than 40 children were crowded into the classroom with only one teacher. As the grades advanced, however, the number of children in the classrooms declined. Some children were forced to stay home and work, tending to cows and goats; some of the girls—some as young as 10 to 12 years old—were married off in exchange for cows and goats; and many children died from malaria and other preventable diseases.

My initial reaction to the children was horror; I was not prepared to see mucous of all colors pouring from their eyes, noses, and ears and flies burrowed in the mucous. Most of the children did not have shoes, and their hands, feet, and clothes were filthy. Many had shaking chills and high fevers as well as sclera jaundice. The scene was extremely traumatic for me especially as I work in a bone marrow transplant unit, a place where no one is allowed access with even a trace of the common cold let alone any kind of infectious process.

I felt so torn, so guilty. These innocent, poverty-stricken children wanted to be held, and I was afraid of touching them and of them touching me. I was ashamed of my reaction. Nothing could have prepared me for the state of these children, not words, not even pictures; and I could not wait to leave and go back to the camp.

As I walked back to the camp, I could not get over what I had just witnessed. At dinner, I couldn't eat. How could I when I knew the only meal those children had had that day was lunch? How could children who appear so sick seem to enjoy life so much, evident by their smiling, playing, and singing? I had 4 more days to make a difference, and I knew that I to change my frame of mind. I needed to put the sickness, hunger, and poverty out of my mind and perform the work that I came to do, including assessing, treating, and holding these children.  

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