Askari Serpent: Doctors in the desert

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Nabeela is a captain in the Royal Army Medical Corps and a surgical registrar at the Queen Elizabeth Hospital Birmingham. In this blog she discusses her recent deployment to provide primary healthcare outreach in rural Kenya with 2 Medical Regiment.

I was fortunate that my trust approved two weeks of military leave, at relatively short notice, to join a medical unit that was deploying to Kenya and required a medical officer. 

I arrived in Nairobi and quickly went to Nanyuki for a period of acclimatisation, including physical training at sunrise in the shadow of Mount Kenya. I then moved north into the territory of the Samburu tribe. I went through Archer’s Post, known affectionately by British soldiers as Archer’s roast, where temperatures reach 45 degrees before midday. I met a few anxious soldiers who were worried after sightings of camel spiders and a brown scorpion on camp. Fortunately, a landrover carrying medical supplies took me to our first outreach location. Here, I joined the team of 30 people whom I would live and work with for the next two weeks. 

In the span of three hours we turned an empty field of thorny plants into a tented medical facility. This included a reception area, education area and a pharmacy tent. We had three further consultation tents and a dental tent equipped with steriliser and equipment for basic extractions. Behind this we erected our accommodation tents. We were entirely self-sufficient and carried all of our food and emergency equipment with us. Water was in limited supply and we used this sparingly. Despite this, our handwashing stations impressed our healthcare governance lead, who was very pleased that there were no outbreaks of diarrhoea amongst us, despite many patients coming to us with these symptoms.

We moved location every two to three days. Each day we saw patients from 8am until dusk. It was difficult to turn away mothers who had walked several hours with their children to see a doctor. Our highly motivated sergeant, who was a practice manager in the UK, ensured that patients flowed seamlessly through the education, consultation and pharmacy tents. The Samburu women arrived bare chested, adorned in elaborate beaded jewellery and colourful shuka (an african blanket) or sarongs around their waists. Most of our patients had received no formal education and held traditional health beliefs. They had little contact with conventional doctors and nurses and often resorted to boiling leaves of the mwarubaini tree, also known as the tree of 40 cures. Scientists know that this tree contains an aspirin-like chemical in it, sadly, it is ineffective in treating the common infections of tuberculosis and gonorrhoea, both of which were rampant in this area. 

Rather unexpectedly, I was summoned after dark to see a young tribal warrior who had been bitten by a venomous puff adder snake. His friend had killed it and brought it along in the hope that we carried the antivenom. Sadly, we didn’t but we were able to point him in the right direction. Another unusual patient was a young shepherd who had been bitten by a lion and had a humeral fracture. We referred him to the nearest orthopaedic department that was at a hospital 60 kilometres away. 

All in all, it was a very stimulating and challenging two weeks from a personal and professional perspective. It was back to basics with diagnostic equipment. Clinical judgement was the single most important tool in helping people. I returned to my NHS job feeling invigorated and appreciative of our NHS infrastructure. I know that my employer values the adaptability and leadership skills that I develop through having an Army Reserve career. I feel very fortunate to have two synergistic careers in parallel to each other. I would highly recommend the Army Reserves to any NHS staff wanting to augment their skills and gain life experience.

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