Setting Up, part 3

I’m met an 11-year-old girl today who, barring a miracle, will be dead in the next 24 to 48 hours. She’s a beautiful young lady who came to the casualty (emergency room) where I was working, vomiting, hallucinating, and very agitated. After medication she calmed down and called for “Doctor Mzungu”. I went over to her gurney, and she wanted to “give me a high five”. I did the “go low, too slow” routine, and she was delighted.

She was bitten by a rabid dog a few weeks ago, and was treated with some antibiotics. A week later, she was called back and appropriately started on Rabies shots, but only had one and never returned for the other shots. Even at home we don’t have effective treatments for rabies once it is in the central nervous system, and here we have even less. The poverty of resources and of understanding her condition led the family not to avail themselves of the treatments, and now there is nothing humanly possible to save their daughter. Through my tears and the memory of her smile, I am reminded why I am here.

What if we had a clinic located in her neighborhood, where the goal was not to make money, but to educate as well as treat the patient in the context of her family situation? What if, through our computer software system we were sending cell phone reminders to her parents to return, and being prompted to call them to find out what was going on if they missed a visit? What if we could set up a system where we could incentivize parents to follow through on preventive care, not just for vaccinations, but to receive education and encouragement in a family medical environment? That’s the dream! What if? Then this vivacious little girl would have a whole life ahead of her.

So it is worth it, even though there can be frustrations. I ended my last blog by stating the last registration hurdle had been overcome. Well, that was not quite the case. It was ready for review, and that review was not good. The instructions clearly said to submit the documentation either in JPEG or PDF format, so several of the items were just photographed and submitted. My application kept getting returned because they were wanting me to resubmit several items, so I kept recopying everything and sending it back in, only to have it rejected again, after a 4-7 day review. Judi was kept busy at home sending documents that I thought I needed, but it was of never enough. Last Sunday, in the rejected column, I got a message from someone in the bureaucracy, saying cryptically, “Come to Sheria house.” That is the Office of the Attorney General located in Nairobi. So I caught the 9 pm bus, arrived in Nairobi at 4am with plenty of time to walk the 5 blocks from the EasyCoach bus station to Sheria house by 8:30 am when it opened. There I was informed that all the documentation had to be in PDF format ONLY, and that was why it had not been accepted. I could not figure out how to change a picture into a PDF file on my phone or iPad, so I had to resort to Cybercafe in the building across the street. Tina was very helpful in getting files on my email sent to her, changing them and sending them back in PDF form, so I could sign them, and return them to her, so she could send them to me as a PDF file again. (Note: I could not just print them from my email on a cybercafe, because my email insists on protecting me by sending a message to my phone, which I am currently using a Kenyan SIM card in, so the message is inaccessible-I love security!) With everything on my phone in place, I returned, and in review, found that I had not placed the Lot number on the address in the right order, and since I had already submitted the form again, it would have to be rejected and opened for corrections again.

Rather than wait 4 days for that to happen, the lady at the help desk took me directly to the person who was handling my case, who was very helpful in assuring everything was in order - which it was not! Apparently, it had not been communicated to me well that I needed to have the American business license and the constitution notarized- and not just notarized, but notarized in the country of origin.

So, back to my ever helpful wife Judi, who fortunately had the next day off, and was able to get a notary to sign that she had seen the documents, since of course there were no signatures to be notarized. And so, after quite along time, it seemed as though the process of registration was about to be complete. Then everything else could fall into place: beta PIN from the government, get the bank accounts open, secure the site for the clinic, and get started on the equipment and personnel. Again, the personnel at Sheria house were very helpful and were really trying to do their work efficiently. The barriers to getting things done here are not lazy, uncaring or incompetent people, it is the systems they are forced to work under, with shortages of literally everything, including electricity. It is not so amazing that things sometimes go slow. What is truly amazing is that so much actually does get done eventually!

Anyway, as I sighed a breath of relief at seeing the end in sight, she said, “Now, we will send your application to CID (the national intelligence service) who will vet you, and then you will be ready to go”. Naively, I asked if that would be done in the next 2 weeks I had remaining in Kenya, and was informed it would be more like 3 to 6 months! And that I could expect a call on the phone, my Kenyan phone, which of course is not active when I remove my SIM card at home, so I guess I will be carrying 2 phones for a while. Too bad Apple doesn’t have dual SIM cards in their phones!

One afternoon I found myself talking with Aggrey Anditi, a friend and local businessman at his Abala Centre, outside of Korowe. His suggestion was to just give it to a lawyer, and have them do it. He even offered me his lawyer, but unless there is something else missing here, it should be done. Literally everyone says to avoid the lawyers here, and no one seems to trust any lawyers except their own. But if this doesn’t go through, the next try will be with lawyers!