Lena Makaroun

0000022001-Lena PictureInternal Medicine Resident, UCSF

Suba, April 2015

My time in Suba was deeply rewarding. Though I have traveled to many parts of East Africa before, this was the first time I had the opportunity to experience health care delivery in a rural setting. Over the course of just four short weeks, I have had the chance to spend time in a number of different health facilities: Suba district hospital in Sindo, Mbita district hospital in Mbita, Sena clinic on Mfangano Island, as well as many field sites that FACES supports such as clinics on Ringiti island, Remba island, and Humanist and Waware clinics on Rusinga.

 At the larger sites (district hospitals and sub-district hospitals), FACES services are integrated into general Ministry of Health services. Here, I spent my days seeing HIV positive FACES patients alongside experienced clinical officers. Most patients arrive early in the morning with the hope that they will be seen quickly so they can get back to their work – most commonly agriculture and fishing. The clinical officers work with amazing efficiency, by sequentially screening patients for opportunistic infections, asking about family planning methods, medication adherence and any other problems. Clinicians also use these visits to make sure clients are up to date on viral load testing and other necessary lab work (creatively managing such services even in the most remote settings!). I also had the exhilarating experience of working with pregnant women and mothers with small babies in the ever-busy Maternal and Child Health ward at Suba District Hospital. One of the most fun experiences was participating in circumcisions with the Voluntary Medical Male Circumcision team as part of a campaign to reduce HIV transmission. This team tirelessly does outreach in the community to recruit boys and men to be circumcised – they even recruit in the middle of the night to reach the nighttime fishermen!

 Aside from my clinical work, my time in Suba has brought immense personal satisfaction. Despite the short time, I had the chance to make meaningful friendships and bonds with my colleagues at FACES. Everyone I met was so open and welcoming to me, showing an amazing generosity of spirit. I was able to witness their hardworking, resourceful and empathetic care of clients, despite many nuanced challenges. I will take back with me that spirit of tenacity and generosity. As I leave Suba, it is these connections that I will cherish as the most valuable part of this experience.


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