Challenges Created by Foreign Assistance

It is hard to believe that my time in Kenya this summer is coming to a close. Amongst all of the farewells and final reports I have spent most of my final week in the field, working on my project. This involved learning a lot about how the health and living systems in Kenya operate. Dan, Kamari, and I are staying with families who live within Kisumu. However, if they ever refer to their homes they mean the rural village their family comes from. Within the villages families have multiple houses on the same plot of land and their farms surrounding them. The communities also have paths through the farms to get to the other families’ homes. The villages I worked in both have a central town area with stores and healthcare centers. But the homes are often very far from these centers. Therefore, private facilities have community health volunteers (CHVs) who work within their more remote areas helping refer those who are sick to the doctor. After training six CHVs on how to take vital signs and use telemedicine I went to all of their villages to work with them as they began using their new skills. This meant walking through the villages with the CHVs to clients’ houses. The first patient I saw was a women laying on the ground outside with her head resting on a cloth that had been placed on a piece of wood. I soon found out that she had stage III uterine cancer but was receiving no treatment. After speaking on the phone to the doctor at KMET we were able to prescribe multiple medications to help her. I felt so sorry for this woman who must have been in terrible pain but only had the ground to lay on in the heat with bugs and animals all around her. But after we left her house I continued to see even more troubled patients. One child had cerebral palsy but the parents had stopped taking her for exercises after another child had been born, and another woman had extreme arthritis and could barely walk but with just the few minutes she had to wait before the doctor called back she got up and started working. Another man who was also suffering from arthritis wanted to consult the doctor for free. He told me that his son was being sponsored by a white woman to attend school, so I should sponsor him. He gave me multiple impassioned speeches about how great sponsorship is and why I should do it to. I explained to him that the Huduma Poa Sky program at KMET was created to be sustainable and therefore had to take advantage of locally available resources; sponsors could not pay for the entire thing. Fortunately he understood and was able to consult with the doctor. However, this assumption, that foreigners are present to make things free, also challenged me while working with two CHVs in a different community.

The following week I was in a new community with two CHVs I had trained. They were hesitant to mention the consultation fee in all the homes we visited explaining that people would automatically shy away and stop listening once they learned it cost money. This upset me because I wanted all of the people I met to get medical care and feel better. Later a few people called out to me in Luo while we were on the road. The CHVs said they were asking for medications because they saw I had a bag and assumed I must have free drugs with me. All of the support foreign countries offer developing countries is great. But the assumptions it can create are not always the best. Because there were assumptions that I was there too sponsor people made it more difficult to convey to people what telemedicine is and how it will help their community.

Alexandra Siegel ’16