Time means nothing. I'm doing a lot of sitting around. I guess the North American way is based on efficiency. That is not the African way. Disorganized. But on the other hand, with the very limited resources, I am finding people very passionate, book smart and willing to do what it takes to get optometry on the map here in east Africa. I hope that I will have the patience to go with the pace here.
The guest house that I am staying in is basic but clean. The washroom is tiny and the shower head comes out from the wall at the usual height with a bucket underneath. I stand in the bucket to wash with the trickle of water that I get. No hot water yesterday but I'm told it's coming.
Dr Emmanuel, the head of the department is the one and only instructor. He now has 2 masters student to help him and me. But so far I'm not being utilized.
Again everyone is warm and friendly. This is really an eye opener.
I'm a happy camper today! After the initial frustration this morning of having to wait yet again for the grad students; once we got going, it was very productive. I taught them to do a subjective refraction with the phoropter. Surprising that they don't know after graduation, but with all the challenges this program has, I am beginning to understand why this is the case. One person has been teaching all 4 years all the subjects. They did have other professors come but red tape with work permits and who knows what else, drove them away. Only one masters student has some years experience so he gets respect from the students. The others are only recent grads knowing not much more than the 4th year students, so the students know how much (or little) they know. But again, I have to compliment two of them with their passion for the profession that is in its infancy in this country. And of course, the director of the program, Emmanuel, deserves so much of the credit to keep this dream alive. Lunch time, Timothy, the masters student who graduated in 1998 from Nigeria, and Andrew, the recent graduate from the Kenyan school, was spent eating local food. I had fish and ugali which is a bun made of maize. Excellent flavours.
Afternoon was spent with the 4th year students. I taught them cover test, Maddox rod (I had to remember the basics) and Worth 4 dot. I showed them the parts of the phoropter which they still have never used.
I will miss the passion of Dr. Tim, Dr. Andrew, the 4th year students and particularly the frenetic Dr. Emmanuel.
I will miss the warmth of the people, their smiles (with the most beautiful teeth I've ever seen), the special Kenyan handshake, warm milk with my tea, Elizabeth at the guest house, eating with my hands and eating juicy mangos in the morning. I will not miss "African time", the blackouts, wondering if today will be the day that I get hot water in the shower and the disorganization.
I wanted to help and I did teach them some skills in the one week I was here. It was a drop in the bucket though.
I sent an email to the PG's (post graduates) last night to let them know I would meet them at the clinic at 9:00 am to teach them gonioscopy. Most were there but somehow not ready to get to work until 10:00. The 4th year students were to come at 10:00. Some did and some showed up at 11:00. If I do this again, I will insist on punctuality and organization as a condition to my agreeing to volunteer.
We successfully did gonioscopy with the 3 and 4 mirror lens. The students were so excited about even getting the lens placed on the cornea correctly. We all watched a video from a great site online gonioscopy.org and they will all have access to it. We broke off into groups some practicing gonioscopy while others were working on BIO and slit lamp dilated fundus exam. These were all new skills that they hadn't even tried before.
In the one week (but probably only a total of 12 hours of work), they learned cover testing, Maddox rod, Worth 4 dot, subjective refraction and binocular testing with a phoropter, BIO and slit lamp dilated fundus exam. We started gonioscopy today. I spent a couple of hours teaching a paediatric exam to the PG's and an intro to OCT for Dr. Tim.
When time was done, they all wanted pictures with me and I did hear the word "Mzungu" again. Not sure I can take that in the spirit it's meant. One student said the picture of the two of us is to demonstrate contrast sensitivity! That is a hilarious inside joke for us optometrists!
They all thanked me, shook my hand, asked me when I'm coming back and gave me a Maasai beaded bracelet in the colours of the Kenyan flag. They all want to be in touch with me and I've offered to help them remotely as best as I can.
What a wonderful group of students! I’d love to see them all again!