After viewing the international newscasts of famine and civil war in Somalia during the second half of 1992, I made the decision to do service work somewhere on the African continent. The trip became a voyage into my darker sides, without the assistance of a familiar culture or friends.
I had spent the previous nine years in private practice in Santa Fe, New Mexico. The last two years and been quite serene. That was all about to change. In Feb. of 1993, I left for Nairobi, Kenya, resume in hand, looking for an organization that could use an extra pair of hands.
February 13, 1993 -- Arrived in Nairobi at 10 p.m. The cement walled and linoleum floored airport was filled with soldiers with AK47s. Waited for several hours to get a visa, and kept wondering if my luggage would still be there by the time I got all the paperwork. Finally able to pass through immigration, my bags were the only ones still rolling around the turnstile ... lonely little voyagers. I think they smiled when they saw me.
Feb. 15 -- Bless my poor body. It doesn't know it it is coming or going. Spent the day in Nairobi, exhausted, walking form one agency to another. One major problem of getting established here is my lack of international experience. I guess most people are worried that if they put me in the field that I will freak out. Can't blame their skepticism.
Feb. 16 -- Busy day, walking around Nairobi visiting NGOs (nongovernmental organizations). Visited at least a dozen relief agencies; one agency was more interested in my livestock experience than my chiropractic background. I had little snit fits by the afternoon. When tired, my patience with life leaves me. The trip so far has been a humbling experience. I just need to keep a sense of humor and a serene heart while the blisters on my feet mount.
I eventually found a position with the International Rescue Committee, volunteering as a monitor of community health workers. They were sending me up to the Kakuma refugee camp in Kenya along the Sudanese border. I would be working with community health workers in the camp, refugees that have been trained for three weeks to identify the more common health problems (TB, malaria, typhoid, meningitis) in their communities. The camp is home to refugees from the Sudan, Ethiopia, Uganda, Zaire, and Somalia.
March 25, Kakuma refugee camp -- I know I'm not in Kansas anymore. Flew up to Kakuma, a flight of several hours in a small twin-engine plane. The plane landed in one of the more desolate places on the planet. Hot. Breathing was difficult. There were about 50 Africans to greet the plane. I imagine that some were Turkana (local tribe) and some refugees. They all stood around and just stared at the new arrivals, finding relief in the shade provided by the wings.
Coming into the U.N. compound, I was struck by its starkness. A chain-link fence topped with barbed wire encircled a scattering of buildings. What does the fence signify? Are they locking in or locking out?
I was immediately put to work at the hospital, screening Ethiopian and Somali refugees until 5 p.m. What a reality check. I screened a an orphaned 12 year-old Ethiopian boy and his two sisters. One of the sisters had the worst case of scoliosis I have ever seen. She's 6, and has trouble breathing because of the bone deformity. The other sister, 2, had malaria. They had walked from Ethiopia! He kept hugging his younger sister, just wanting some help. I could pick them all up and shipped them home. My heart wept for his circumstances and the fact that God has blessed them with such an incredible will to survive. I am embarrassed by my petty problems.
I spoke with an MD in the camp. She has some people she would like me to see. There is one man with a possible neck fracture, yet they don't have x-ray equipment to confirm the diagnosis. Lots of TB and polio. Hard to say what their skeletal systems look like under these ravaged exteriors. I don't think I will do any forceful adjusting on the refugees. I can be more effective doing soft tissue and nonforce adjustments along with teaching some rehabilitation skills. There is a lot of rehab work needed for the war wounded.
I went to the "hospital" before coming back to the compound. I saw things I have only read about. I know that I am where I am supposed to be yet none of this makes any sense to me at the moment.
It looks like there will be some long days. Monday through Saturday 8-12:30 and 3-6. There are about 35 relief workers in the compound. The camp has 40,000 refugees with more arriving daily. The camp appears fairly peaceful yet there were some quarreling factions that resulted in a refugee being shot and another injured just last night.
The kids are incredible. while waiting to be picked up today, I was playing with four little boys. We were drawing pictures for each other in the dust, giggling the entire time. I can't even begin to imagine what their young eyes have seen, and yet as all children everywhere, they just want to love, be loved, and laugh.
My heart broke on a regular basis today. I held a young child about four months old for about an hour while her mother was being treated. The child was burning up with malaria yet she never cried. I just kept stroking her head and she slept for the most part. Her little body was so thin. God has given some people some very hard paths in this lifetime.
My official duties are to visit the 45 community health workers and look in on any problems they have identified. The hospital has 30 beds, with adults doubling up while children fill the ward beds with as many as possible. People lie on the floors; flies attack your eyes; smells of decay, urine and feces. There's lots of malaria, TB, thyphoid, and bloody diarrhea. I remember going over these tropical diseases while in school. I felt Dr. Carr's class was a waste of our time, knowing that I would never have to diagnose or deal with these problems in my practice.
I saw my first guinea worm today. The Guinea worm is in the blood fluke family and migrates to the ankles usually, although I saw a woman with them coming out of her breast and vulva. You can actually see the worm traveling down the leg, just under the skin. The ankle swells and abscesses. The worm, about 6-8 inches, comes out. Each day you can pull them out a little further.
The one MD here, Gita, is an Indian woman who lives in England. Her energy level and dedication amazes me. I pray for the strength to keep going until August, and yet most of the workers have been doing it for a year or longer. I'm writing by flashlight as the generator went off at 8:00. I think I'll close and lie my weary body down.
B. Calico-Hickey, DC
Santa Fe, New Mexico
Editor's note: "Calico's Little African Adventure" will finish in the 12-16 issue.
Many relevant diagnostic signs are not performed deliberately by the examiner or by the patient at the examiner’s direction. They are observed as the patient reacts to their condition. Fortin’s finger sign, Minor’s sign, and Vanzetti’s sign are three examples of this principle.
Spearheaded by burgeoning scientific and clinical research literature, psychedelics have reached a level of media coverage and popular interest that has not been seen for over half a century. By “psychedelics,” we are referring to the unique class of substances that includes psilocybin (the active compound found in so-called “magic mushrooms”), LSD, dimethyltryptamine (DMT), ayahuasca, 5-MeO-DMT, and mescaline – each of which occurs in the natural world (except for LSD, which is a semi-synthetic compound).
While working at the Lovelace Medical Center in Albuquerque, N.M., one of the primary care physicians stated that imaging every patient prior to receiving chiropractic was not medically necessary. It was at that point I reconsidered the need for the imaging of every patient to avoid malpractice.
