We've been home for a few days now and most of the trip has had time to process. The GI distress has subsided (for the most part), and I think I have some perspective on the whole thing.
All in all, the trip, and all of its individual parts, was an astounding success. We elevated 16 high-caliber medical professionals to the level of AHA Instructor in one or more disciplines, the 8 individuals chosen to breathe life into the fledgling Paramedic program were left well-prepared to make the big leap in January (The program is actually full! They had 18 students registered, simply by word of mouth advertising, before we were done reviewing the National Standard Curriculum!), and great strides were made in the area for fire service education. This was, by far, the heaviest lift we had to make, and both Kevin and John pushed, pulled, prodded and yes, lifted, to get some semblance of standardization.
Moving the fire service from where it is, to where it could be, will continue to be a huge project. We are fighting limited resources, antiquated ideas about fighting fire, mediocre previous training and a society that simply hasn't embraced the value of aggressive fire attack - although the recent destruction of the biggest airport in the country by fire is highlighting some of the issues inherent to their current posture. The work is ongoing, and the Kenyan instructors are exuberant and eager to start making things happen. Time will certainly tell if our work will initiate any lasting changes.
As I've re-integrated into home-life, I'm left with some experiences that, maybe didn't change me, but certainly have left a lasting impact. The first, and foremost, is definitely the garbage fires. I almost wrote an entire post about the daily practice of burning trash in Kenya. It didn't seem to matter which part of the country we were in, either in the early morning or late afternoon, or both, everyone burns their trash. In some neighborhoods, it seemed like everyone pooled their garbage and set the whole, huge pile aflame. Everywhere you turned, something was burning. Maybe this has had some influence on the attitude Kenyans share regarding fire, maybe it accounts for the lackadaisical early attempts to control the airport fire...who knows, but the smell hangs heavy in the air nearly constantly. More than once, the plume of smoke caught my attention and made that fireman bit of my brain go bonkers. I distinctly remember the first night, driving from the airport to the hotel, and seeing a little fire burning, unattended on the side of the road. Coming from the U.S., and doing what I do for a living, you can imagine my difficulties with simply driving by, allowing the fire to burn there. It breaks with everything we're taught, from Smokey the Bear public safety announcements during Saturday morning cartoons, to the fire extinguisher training that I got as a freshman in the college dorm, we don't let fire burns. Apparently, in Kenya, it's not only "OK", it's expected...hence why they allowed the busiest airport in East Africa to burn down!
Clearly something else that has stuck with me is the shower situation. I still have some latent PTSD surrounding taking a shower. Even as I claw my beloved shower curtain back to climb into my garden tub at home, my heart races a little bit and I worry that I'm going to re-create Lake Goldstein...and Mrs. Goldstein is club me like a baby seal, unlike the cleaning lady's who probably were just happy to have a job siphoning water off of my bathroom floor (There's a 42% unemployment rate in Kenya! "Suck water off the floor? You bet! Straw or Shop-Vac, makes no difference to me Boss!")! But really, I love my shower curtain. I was not aware I could miss an inanimate object that way, but if I'm ever re-deployed to a curtain-less region of the globe, I'll probably be thinking about packing a collapsing rod and shower curtain...to help mitigate my stress disorder of course!
Driving seems to have clicked back into place. I did have a subtle urge to slide to the left side of the road for the first few minutes, and I certainly wanted to push a car off the road the other day (but that really had nothing to do with being in Kenya), but for the most part, I will relegate my memories of the roadways of Kenya to just that...memories. It's kind of like riding the rides at the county fair (you know, those conglomerations of moving parts assembled by individuals incapable of taking care of their own teeth), I'm glad I experienced it...and survived, but the tiny bits that I remember end up being way more interesting than the entire experience itself.
Lastly, I'm left with the the people. We met some incredible people over there. Firemen, Nurses, EMTs and Doctors, that will do almost anything to see their industry and their country advance. Although it was clear that some had additional, and arguably ulterior, motives for involving themselves in the projects, most simply sought to make things better. It is through the power of these folks, that progress will be made.
KCEMT will be offering a Paramedic Program in the next calendar year. They're not waiting for a consensus or a governmental decree, they know it's needed and they're willing to let it iron itself out AFTER the medics hit the streets, rather than wait to see when and/or if anyone decides it's a good idea. The AHA programs are spreading through Kenya and the surrounding countries faster than the KCEMT can teach them. Just months prior to this trip, one of the biggest private hospitals in Nairobi mandated AHA BLS and ACLS for all of its nurses. While this seems like a no-brainer for us, it is a massively progressive move over there and, as far as i know, the first (and probably not the last) of its kind.
Once the fire service can prove its value on a national scale, doors will start to open for change. I almost feel like they need a "win". If the guys that we taught, or maybe some of their first students, can apply something they learned to stop a fast moving fire, or save a victim, anything that can prove the power and value of a well educated, equipped and manned fire service, the tides will change and they'll no longer have 10, brand new donated fire engines sitting in customs. And that part they need to get the only fire truck in a particular region will get through the red tape and into the hands of the mechanic just dying to fix the truck meant to protect his house. And maybe they can get the support they need to get a few air compressors running so the air packs that they have, can finally have breathing air in them!
Shorty before I left, I was asked, "Would you come back?" I have to say I would. The trip there and back is pure torture (unless you're in those fancy seats at the front of the plane! can you believe those things? I mean, I had a dorm room that weren't that big!), the food, I'm sorry my Kenyan friends, is pretty bad, but most of the challenges are surmountable with a little patience and a good dose of humor. And any of the hiccups and speed bumps dissolve away when compared to the satisfaction of being able to jump start change like we did. We offered a spark and now we get to watch our compatriots turn it into a national fire (no, not a trash fire!). I can't wait to see where they'll be in a year!
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