day eighteen

I am slowly learning that I actually know things.

Whilst working in Australia and England, I was always having to check my work with supervisors, constantly feeling inferior, and completely unsure of what I was supposed to know. I finished my two Masters degrees with no confidence whatsoever in my abilities as an infectious disease field epidemiologist.

Whilst I still question my ability to get a "real" job as an Epidemiologist at this point, what I do know is that my Masters in Infectious Diseases was not a complete waste of time. In fact, it is this training that has cemented my belief that this internship is the right thing for me to do right now. I have gotten out from the cynical, micro-managed, compartmentalised institution that is developed countries and government departments, and found myself in a place of possibilities, where I am able to marry public health with laboratory practices, and where I genuinely know things. Each day my confidence gets better and better.

Where I sit to write this blog post. The wind has picked up dramatically and blows through the office. Hopefully that's a sign that the rains are coming, because it is stinking hot during the day here!

Today I diagnosed a patient with Entamoeba histolytica - a parasite which causes diarrhoea. Whilst it is horrible for the patient, and I pray they have a speedy recovery, it is pure excitement for me as it proves two things - one, that I know my parasites and two, that there is a problem with water-borne diarrhoea, specifically parasites, here in Kakamega. I have been told by clinicians that there isn't a problem with parasites, or Chlamydia, or this, or that; however, the laboratory is currently using methods which are not sensitive or specific enough to determine these things, therefore you cannot tell me there isn't a problem, nor can I tell you definitively that there is a problem, until we rectify the situation with the testing methods and determine the prevalence. Data is key my friends.

The laboratory service delivery charter. For all those people who think "if we had a medicare co-payment people would stop coming to the doctors" then you should take note - most things aren't free in Kenya (only HIV and TB treatment, medical treatment for children under 5 years and antenatal care)

Each day I come to work I am excited about what I will discover - the other day I learnt that someone had previously come in to try and network the hospital so that everyone could use computers but never finished the project, or today I learnt that we have all the chemicals and equipment to start testing for Cryptosporidium spp. through florescence microscopy. If I had not done the two different Masters degrees, if I had just done the one Masters of Public Health like everyone else, then these two discoveries may not have been so important. But for me I see potential in both of those things to impact the Ikolmani sub-county community for the better.

You might see the Ebola poster, but I see the networking cables.
No, there isn't Ebola here, everywhere has these posters up as precaution.

Thank you God.