Page 18 - QARANC Vol 14 No 10 2015

16 QARANC THE GAZETTE
In the second phase of our deployment we moved north to tribal Samburu region, in order to conduct a recce for 33 Fd Hosp (who will be deploying on the next Ex ASKARI SERPENT in Aug 14). The journey to Samburu was arduous and took 2 days due to poor road conditions. This was however compensated by the fact that we had lots of safari photo opportunities en route, including elephants, giraffe and zebras!
We combined the recce with an opportunity to provide some PHC to the local population and set up our MTF in 2 villages. The Samburu locations were very rural and isolated and required a different approach to the access of our care. Tp Comd Capt Sloss performed admirably in resolving a tense stand off that resulted when the Pokot tribe arrived at the MTF demanding care. The Pokot and Samburu tribes have been fighting each other for decades over cattle, land and watering hole access. There was the potential for an outbreak of violence but the solution was to offer alternate care to a Samburu or Pokot patient. Needless to say our quota for the day increased and we happily worked extra late that day.
My main role during this deployment was to provide clinical supervision and support to the CMTs and included opportunities such as delivering training on a variety of areas such as wound care, administration of I.M. medication or assessment of children and babies. Another critical aspect that required close supervision was the dispensing of medication. As one of the more high-risk activities, it was essential that the CMTs were provided with adequate training and assessed as competent to assist in the dispensary.
The clinical experience we all gained from this opportunity has been immense. We have been able to triage and treat a large number of presentations that are rare or absent in the UK population (from simple illnesses such as mumps to the more exotic presentations such as necrotic snake bites). It was great to affirm the fact that our CMTs are trained to an excellent standard and have the pre-requisite skills to deliver high quality care in a contingent environment.
On a personal level I feel the opportunity to deliver PHC to the Kenyans has been a true privilege. I defy anyone in the caring professions not to be affected emotionally by the extent of human suffering that we were witness to. I was shocked on a daily basis by the extent of poverty but was inspired by the resilience and optimism present in all the Kenyans we were fortunate to meet. Irrespective of the political reasons for delivering the health care, I am proud of the fact that we have made a real difference to a significant number of Kenyans. Maj L Gaal QARANC
The Primary Healthcare SNCO
Nurse
After submitting my penalty statement for Exercise Askari Serpent, I did not expect to be as lucky as to be picked to augment 5 Medical Regiment for the exercise as I had just returned from a two year posting in Kenya. However shortly after submitting my penalty statement I received an email stating that I had been picked to go.
On Friday 28th March 14 I headed down to South Cerney where I was warmly welcomed by 5 Medical Regiment personnel. We were processed through MCCP then boarded coaches to take us to RAF Brize Norton. After an eight-hour flight we arrived at Nairobi International Airport, which was still undergoing major construction work following a fire that ravaged through the main terminal building on the 7th August 2013. We boarded coaches and headed to Nanyuki, a town approximately 200km north of Nairobi. Some people were exhausted and slept on the coaches but the Kenyan scenery
was just too beautiful to miss despite having travelled on this journey many times before. The Kenyan hospitality is second to none and as we passed through little villages and towns, people would stop and wave, children would run alongside the coaches smiling and waving frantically, shouting “mzungu” (Swahili for white person). We crossed the equator into the northern hemisphere and into the town of Nanyuki that would be our home for the next couple of weeks before deploying out into remote locations. The coaches pulled into Laikipia Air Base East LAB(E) where we disembarked, collected our bags and set up home in 50 man billets.
The first couple of weeks were spent trying to acquire essential kit and checking what little kit we did have. We also managed to squeeze a few days of adventure training and a safari into our busy schedule. It was awe inspiring waking up every morning to the view of Mount Kenya, the second highest mountain in Africa reaching a height of 5199m above sea level. A few days before we deployed out to our locations we were joined by members of the Kenyan Army who were supporting us throughout the exercise.
After an early breakfast on the 12 April 14 (not sure of the date) 3 Troop conducted their final checks, loaded up their vehicles and set off for a little town called Mutuati in Meru County. We set up on a grassy slope in the grounds of the district hospital. A tent had been left in location by a US Aid organisation so using this to our advantage we set up the MTF inside the already erected tent. Word spread quickly of our arrival and before long many onlookers had congregated around the location watching our every move intently. On our first clinical day queues of people had gathered from the early hours having walked for miles in the pouring rain to find a treatment or cure for the many ailments they presented with. It became apparent from the outset that expectations of what we could do or provide were far greater than what we actually could provide. It was heartbreaking to see people presenting with such high hopes and expectations only to have to tell them that we did not have the capability to provide what they required. It did give me comfort however to know that we were providing the best possible care we could within the constraints of our situation. One of the main issues we had on day one was the lack of translators who knew the local dialect.
Kenya is a linguistically diverse country and although English and Swahili are the two official languages in Kenya there are many unique tribal dialects. Initially this slowed us down considerably but thankfully the locally community rallied round and by day two we had numerous volunteers to assist with translation. Most days we would see around eighty to one hundred patients, the majority having poorly managed chronic conditions, and every day we would have to turn patients away due to the overwhelming demand.
After a week in this location we packed up and headed back to LAB(E) to replenish supplies. We had a couple of days in LAB(E) replenishing and sorting out kit but we were all glad to be back on the road again and heading out to our next location, Lailuba, another small farming community in Meru County. After decapitating a black mamba snake that had made its self at home in the main treatment area we set up the MTF in a partially built maternity ward within the grounds of the local health clinic. We spent a few days treating here then packed up and moved on to our final destination, (can’t remember the name of our last location) a tea farming community. On arrival we could not believe our luck, a purpose built healthcare facility with running water, flushing toilets and showers in a beautiful location on the slopes of Mount Kenya! This location was a hive of activity with local