Flying Medicine

From the windows of the Cessna single-engine plane, the grasslands of Maasailand spread out below. Circular villages or "bomas" dot the hillsides, and herds of animals run between--cattle, goats, zebra, wildebeests, giraffes, and even ostriches. In the midst of savanna and farmland, a line of dirt appears--the airstrip. We do a low fly-by to ensure that the herds have cleared the field and to notify the people that we have arrived. Then we land.

Standing on the airstrip, there is a not a village or a building in sight, except for the mud hut maintained for the clinic. Through the brush and acacia trees, Maasai men and women emerge in their red, purple, and plaid cloths. Babies are hidden under their mother’s wraps. The villagers gather around the plane and help to carry our gear to the hut. We set up and get started with the clinic routine.

Babies are weighed and vaccinated---BCG, polio, and DTAP for the infants, measles and vitamin A for the toddlers. Medical patients wait in line for the local clinical officer, who speaks Swahili and some Kimaasai. Pregnant women crowd the hut waiting for prenatal care. After helping with vaccines, I become the OB provider. For each woman, I ask how many pregnancies she has had and how far along she thinks she is. Often this takes two- or three-way translation from Kimaasai to Swahili to English. I take her blood pressure, check her eyes for anemia, and press on her ankles looking for edema. She lays down on the bed made of branches in the hut, and I feel her abdomen, assessing her gestational age with my hands. We have no measuring tape, so I recall that the width of my hand is approximately 10cm. We have a Doppler, so when it is functioning properly, I am able to hear the fetal heart tones. I record all of this on the woman’s antenatal card, which she keeps in her possession tucked under her cloth. Then I give her iron and folic acid tablets for the month, malaria treatment, de-worming treatment, and a tetanus shot if she needs one. She is finished and the next woman sits down on the bed.

Once all the steps of the clinic have been completed, we pack up the plane and say our good-byes. Another group will arrive for the same clinic in two weeks. Some of the Maasai wait to see the plane take off, but most of them do not wait. As quickly as they came, they disappear back into the bush.

Over three days, we did seven rural clinics at Loongong, Narakawo, Arkasupai, Ilkiushi Oibor, Lowsaki, and Oiborkishu. We vaccinated over 300 babies, and I did 90 prenatal visits.