Mike Belliere, co-founder of MEAK recounts how MEAK changed Agnes’ life.

Agnes’ story

Here’s an interesting case study that makes one realize just what a fairly small accident can do to the life of a person in Kenya.

 At just 28 years old, Agnes was about to be condemned to a life of disability and ousted from her community. She had fallen on to her left arm more than six weeks before the MEAK team met her.  As a result of the fall she had sustained a complex fracture of her elbow, the dislocated bones had already started healing in the wrong position, leaving her with severe pain and no function.

As the wife of a Masaai warrior, Agnes is expected to build and maintain the mud hut in which the family live.  On a day to day basis she will milk the cows, fetch the water, collect firewood, prepare food, wash clothes, look after the children and much more.  With her left arm now of no use, she was unable to serve her husband and family and with no means to undergo an operation it was likely that Agnes would be cast out of her community.

The surgeons at Nanyuki District Hospital had heard of Agnes’ plight and arranged for her to travel down from her rural homeland to meet the UK team.  With such a severe injury (that was at least six weeks old) the team were unsure of the best way to help her.  UK Consultant Orthopaedic Surgeon and Upper Limb Specialist Archie Hawken and local surgeon Dr Mathenge had long discussions weighing up the treatment options for Agnes and after much deliberation they decided to operate.

During a four hour procedure Agnes’s elbow was re-broken and re-aligned in the correct position.  The bones were then fixed in place with plates and screws.  Amazingly by the end of her operation the surgeons were able to flex and extend her arm as normal.Agnes still has a fight ahead of her, with intensive physiotherapy and rehabilitation required to help the elbow return to full function.  However, the team anticipates that with such a successful operative result she should regain near normal use of her left arm.  Most importantly this will mean that she is able to return to being a valued and active member of her community.

Mike

SUMMARY OF MEAK ACTIVITIES FOR SIX MONTHS TO END OF JUNE 2013

The first six months of 2013 has proved and interesting period for our charity with some very positive aspects to report as well as a couple of set backs.

MEAK has been working in Kenya since 1994 and has been carrying out medical missions since 2001.  We are now recognized as, arguably, one of the most important charities offering free surgery to the poorer elements of the Kenyan population.  One of the problems that have occupied our thoughts for the past few years has been the issue of succession.  Having founded and then run the charity for the last 19 years both Dee and I have been conscious that at some stage we will need to pass the reins on to a younger generation of like minded people.  Happily, we can now see a solution to this problem and several meetings have taken place that will hopefully ensure that MEAK’s valuable contribution to healthcare in that country will be able to continue.

Although neither Dee nor I have any plans to stop working in the immediate future, we have been delighted to have been able to recruit Alexandra Savis to our team.  Alex is an extremely experienced echocardiograph technician who has travelled on a dozen or so of the MEAK heart missions and is passionate about what we do.  She tells us that she is very excited about being more involved with the charity and relishes the challenge of taking over our projects in future years.

Alongside this development, agreement has been reached with our orthopaedic arm, which hitherto operated under the acronym EGHO (Exploring Global Health Opportunities), that the two organizations will fully amalgamate, with the eventuality that the EGHO name will be replaced by MEAK.  This development brings to MEAK an extraordinary organizational and administrative skill-set that has seen EGHO progress from an embryonic idea a few short years ago to the major player it has become in many aspects of healthcare and health education in Kenya.  EGHO is very proactive in training and trauma care and its surgeons undertake many complex and technically difficult orthopaedic procedures during their missions.

During the first six months of 2013, MEAK completed a paediatric heart mission in Mombasa, an orthopaedic mission in Nanyuki, and four outreach eye missions in the remoter areas of Kenya.  Twenty children received open or closed surgery during the heart mission to Mombasa in February.  Twentyfour orthopaedic procedures were carried out in Nanyuki, again during the February mission to that area.  Also, during our four eye missions we screened 3195 people and carried out 209 surgeries mainly cataracts and tarsal plate rotations.  Extensive teaching and mentoring was also carried out by our GRASP-IT trainers during this period.

The above simplifies the bald achievements of the charity in the form of the total of surgical procedures carried out during this time; however, I find that I have great difficulty, when writing these reports, to enumerate the multiplicity and complexity of all the other involvements that occupy our time and energies.  We find that it is almost impossible to confine our attention to the four primary objectives of MEAK ie ophthalmics, orthopaedics, children’s heart surgery and education as there are always myriad other opportunities to help in other areas, many of which are difficult to ignore. These opportunities may be in the form of helping individuals with their medical problems or subsidizing education costs to supporting organizations and groups that have similar aims and objectives as ours.  ‘The Nanyuki–Torbay Health Link Partnership’ is a good example of this kind of cooperation which has enabled us to gain a substantial Government grant to support this element of our work as well as raising the standards of healthcare in Nanyuki – to the obvious satisfaction and delight of the local medics.

I would seek to reassure the reader that the MEAK teams continues to work tirelessly on all sorts of projects in Kenya that match our aims to support and improve the availability of good and safe medicine to the population as a whole.

Rather disappointingly we have been informed by The Mombasa Hospital that after three successful children’s heart surgery missions by MEAK to their hospital, they have decided not to pursue this branch of medicine and accordingly will not be inviting us back.  We are obviously dismayed by this decision, which is apparently on grounds of cost and alleged disruption to theatres and the intensive care unit.  Significant strides had been made by this fine hospital and their staff in the appreciation of the care and rehabilitation of children following open heart surgery and their decision is a terrible blow to MEAK and the PSG group in Mombasa who are constantly looking for ways to save the lives of local children dying from heart disease.  Meantime, we will continue to work in Nairobi whilst we look for another hospital in Mombasa to pick up the baton of this worthwhile and noble enterprise.

In the latter six months of this year we have planned  further heart and orthopaedic missions.  In July we visit Dadaab on the Somali border and in August we return to Turkana in Northern Kenya for a much delayed eye camp. Three further eye trips will take place towards the end of the year.  Most of our missions have comprehensive reports written by the lead participants on their completion and these are available to our readers if required upon request.

Mike Belliere

Founder / Director

M E A K

I love the feeling of the small twin engine plane speeding up the airstrip at Nairobi Wilson airport, the noise that it makes when the engines are on full blast and the following lightness as the plane lifts off the runway. Inevitably a sense of excitement overtakes me.

It’s an old feeling: many years ago I remember taking off the same runway having just arrived from France and on way to Ol Pejeta, a ranch at the foot of Mount Kenya. I felt the same eagerness as the promise of the African bush lay ahead. Today I am on my way to the Milgis just south of the Ndoto Mountains where I am meeting Helen Douglas Dufresne for a three-day stay at Lkanto, her special sanctuary. I get such a thrill sleeping on top of that hill with no cover.

I have been helping fund the costs of the small clinic in Latakwen and I am here to spend some time with Nurse Rita. I have read her medical reports for the last three years and I know  good work is being done. But being a nurse in the bush deep in Samburu land is very different from being a nurse in an urban hospital and I want to see what it entails.

Rita has scheduled a mobile clinic day a good two-hour drive west of Latakwen.  I wake up at daybreak and meet up with her at the clinic. The land cruiser gets packed with all the medical supplies for a day of immunizations and off we go with Francis driving us through the hilly landscape of the Milgis.

It is dry and windy at this time of the year. While clouds hover over the horizon and rain has blessed many rolling hills further to the south, only scattered showers give a little respite.

On the way we stop at Masikita,a village that has grown quite a bit recently because of an influx of migrating herders escaping intertribal altercations in the north.  Villagers and in particular lots of small smiling and eager children gather around the car.  Rita steps out of the car and confers with the elders of the community. Composed and assured she exudes calm and competence; at times when she smiles her face becomes almost girlish.

I love that mixture of equanimity and playfulness. In the midst of daily challenges that dwarf many of my most serious concerns in my life in New York city  I am profoundly touched by her deep love of life and ability to laugh no matter what! I am soon approached by a group of young men, apparently young elders, who speak English. After introducing themselves they ask: “Can you help us find a nurse and pay for her? We have a dispensary but the nurse provided by the government is rarely there.” They have heard that I am the one paying Rita’s salary. They are amazed that someone living so far away from their world is concerned about their welfare while wealthy local Kenyans don’t feel compelled to help. Rita checks on a pregnant young woman who seems to not be feeling well. After checking her for malaria she examines her in her manyatta.

We climb back in the car and after an hour we are driving up a lugga -the local name for dry riverbed – where we encounter a group of women herding a few donkeys and a couple of men sitting under the shade of the acacia trees on the banks of the Masikita lugga at the foot of the Siambu mountains.   It seems that we have arrived at our destination, but where are the patients? I had imagined driving up to a large gathering of patients eagerly waiting for us. I soon learn  that it is not how it works.  Rita confers with the women and it is decided that we are going to set up the clinic on the bank of the lugga under a tree while the word goes out to the various manyattas – hut – in the area.

Rita, Mama Peters, and Esther set up the “clinic” which consists of a weighing contraption attached to a branch, a large container that serves as a desk, and the bend shape of a trunk that becomes a seat. The women then sit down and sip some tea and within a half an hour young women carrying their babies wrapped up in their colorful cloths stroll in with their children in toe. Adorned with multilayered red beaded necklaces their demeanor is strikingly majestic.

Lots of talking ensues, they eventually all sit down in groups and for the next two hours Rita and her team weigh the babies and children, lecture the mothers on health matters and record all findings in a large and unwieldy notebook.

Lots of laughing, talking, especially when the kids get weighed in that strange contraption and without fail scream their heads off. I don’t get a word of what is going on and feel uncomfortable in my outsider observer status. A look of worry does cross the mothers’ faces when it is time to give the shots.  They don’t like their children being hurt and yet they do know that these immunizations have saved many from the deadly effects of measles and whooping cough.  Patience and humor is of the essence.   Two hours of crying babies can drive anyone crazy.  Rita and her team stay focused, unperturbed, keeping their sense of humor while truth be told I do get a bit frazzled by the cries. Fortunately the older children are perfectly behaved and are keenly interested in Rita’s coming and goings.  The babies are given the polio, tetanus, whooping cough, pneumonia and TB vaccines and Vitamin A drops in the mouth.

The women eventually walk away just as casually as they arrived and return to their lives in the bush.  While their world is so far removed from my life in New York city, I can’t help thinking of the many times I sat at the pediatrician waiting for an hour in the waiting room for my babies’ turn to be immunized.

Rita then gives her attention to a group of three young warriors with their hair braided and covered with a reddish clay mixture who want to get tested for AIDS. She pulls out the testing kit, takes blood samples and to their great relief they all test negative! What a surprise when they allow me to take pictures of them. That is a first and I feel privileged. I don’t understand how AIDS can be an issue for these young men in the middle of the bush. Rita tells me AIDS is commonly passed on through open wounds. We pack up pretty satisfied. The day has been productive. Twenty children in total have been attended to.

We drive back stopping here and there to pick up and drop of people, and get back at dusk. The day has been very long and quite tiring for Rita and her team but hugely gratifying for me to see all the good work that is being done as a result of my contribution.

I join Helen and a couple of conservationists around the camp fire while Rita returns to her village where she will be on call and will have to attend to the needs of a young pregnant woman who is not doing well.

This teenager who looks totally dejected is seven months pregnant and it appears she is suffering from preeclampsia and I am concerned that she be taken care of sooner than later. I knew that this was very possibly what she was suffering from having just watched an episode of Downton Abbey where a woman dies of eclampsia after giving birth. (These TV shows can become useful!) Fortunately Rita knows what she is doing.But things are not easy in the bush.  To get good medical help the woman has to be taken to a hospital 5 hours away and her husband says that he has no money to take her there.  I keep bringing the subject up with Helen and Rita, Rita works her magic with the husband, and I find out the next day after landing at my next destination that she has been driven to the hospital in the MEAK land cruiser. I am relieved!

Two days ago I got an email from Helen telling me the woman is doing well and delivered a healthy baby! I was really happy. It is a wonderful feeling to feel like you have made a difference in someone’s life.

It never ends for Rita but she is hugely grateful for her work. Most of all she loves it and it provides for her family – she is the sole provider. She is a grandmother and takes care of her grand child and you can see him running to her at the clinic in the morning, full of excitement and smiles.

Mama Peters is also hugely grateful. She is the sole caregiver to her four nieces and nephews – her sister died and left her with the children.

I ask Rita what she would like to do going forward and what needs to be done. First and foremost the clinic needs electricity! It seems so basic for us but not an easy thing to achieve in the bush.

Rita would also like to develop her midwifery skills and encourage the women to deliver at the clinic instead of in their manyattas. I think it is a super idea and ask her about family planning. I have seen so many babies, small children and unwed mothers that my feeling is that family planning should be a total priority!  I later learn that the population in Kenya has exploded. Thirty years ago Kenya had a population of 6 million.  Today 46 million people live in Kenya!

She also wants to get a certificate to do TPR surgery. Trachoma, which is a potentially blinding and very painful eye condition, is prevalent in the area. Finally she thinks a mobile clinic could be very useful to reach out to the distant manyattas in Samburu territory. There are clearly lots of needs and worthy goals.

Now the challenge is to sort out which ones are the most needed and can be achieved. Funding is obviously the first issue but the follow through and support of the community is also something to take into account.

I think I will start with the most pressing:electricity. A simple scale could do wanders too!

One day Layla, a little girl in northern Kenya, will wonder how she got her name. Her mother can tell her that back in November 2012, a woman from very far away gave it to her while on a medical mission.

Beverly Orthwein, a board member of Medical and Educational Aid to Kenya (MEAK), brought Layla’s mother a pair of crutches donated by the local hospital in Greenwich, Conn., Beverly’s hometown. Layla’s mother had lost her leg and was getting around with the help of an old pipe topped with rags for padding.

As she tried out her new crutches, Layla’s grateful mother asked Beverly to name the baby. Beverly, who has three sons, chose the name reserved for the daughter she never had.

When people hear you’ve been to Africa, they want to know what animals you’ve seen, but for me this particular adventure is also about bearing witness to the kindness of strangers like Beverly and the volunteers who bring medical aid to the people like Layla’s mother. MEAK’s activities span all of Kenya, but this particular region, known as Samburuland, borders Ethiopia and Sudan and is largely ignored by the government and other non-governmental organizations.

Beverly is returning home after the mission, but Dee Belliere, who with her husband Mike, founded MEAK, remains behind with seven of us—Gerry Boyle, Mike Fels, Pascal Luse from the U.K., and Isabel Wilcox, Alexandria Skouras, Celeste Rault, and myself from the U.S. We arrive at the end of this medical mission to begin a fundraising trek we hope will benefit this mission as well as MEAK’s future endeavors.

The 70 mile journey will take us from the eye mission campsite outside the town of South Horr, through the Seren Valley and the Ndoto Mountains to end at the Milgis where the Parsaloi and Seiya Luggas come together.

Of course the animals and birds–the mysterious tracks testifying to the teaming life of this beautiful terrain–inspire the humbling awareness that out here, we are just more animals in the mix. For the next six days, we’ll make our own tracks south through the steep and rocky Ndikir Laurie pass and through dry riverbeds called luggas.

When they’re not filled with water, the luggas appear to be a sort of superhighway for the local herds and herders. Based on the number of animal prints visible in the soft sand, it also seems to be a fast lane for porcupines, hyenas, leopards, tiny deer called dik dik—and every sort of critter that cavorts or crawls.

Our guides, Helen Douglas-Dufresne and her partner, Peter Ilsley, are native-born Kenyans who have been taking groups through this part of the world for 25 years. Emma Hedges, owner of the Desert Rose Lodge, also accompanies us. Together the three of them know every bird, plant, animal track and burrow on the ground and every constellation in the sky, though Pete acknowledges that their Samburu team has a special expertise that comes only from a lifetime spent here.

On our first night at a campsite near South Horr, as the eye mission there draws to a close, dozens of Samburu elders and warriors come together to express their thanks through song and dance. The songs, passed down for generations, seem timeless and free of outside influence, and it is deeply moving to witness a performance so few outsiders have seen.

I know their gratitude is heartfelt and can’t help feeling it myself. We have watched the bandages come off the patients as they smile with delight at their first glimpse of loved ones. They look around in wonder at the world, seeing it clearly for perhaps the first time in their lives.

Despite heavy rains and tribal tensions between the Samburu and Turkana, in four days a medical team of three nurses, one anesthetist and one surgeon have restored sight to 214 people suffering from cataracts and other eye diseases.

The women can return to creating their intricate beadwork, and the men and children can go back to taking care of their livestock. Most of all, they don’t have to rely on a relative or anyone else to guide them.

In the eighteen years since the Bellieres started MEAK, more than seven thousand people—including many children suffering from congenital cataracts and other eye diseases—have been treated. All this has been done with virtually 100% of the contributions. MEAK has no paid employees or administrative overhead, and Dee and Mike donate their personal expenses, as well as their time and expertise.

As usual at the end of a mission, Dee sorts out plane rides to Nairobi for still more patients with conditions requiring treatment at a hospital. Meanwhile Mike is at home in Surrey, UK, planning the heart mission he’ll oversee in a few weeks.

Once we start our trek, we will be off the grid—no cellphone, Wi-fi, Internet. We will be “on safari,” but there are no jeeps, game preserves or posh lodges.

This is an area so seldom visited by tourists that some children have never seen a white person, which is why we can’t take it personally when one look at us makes them burst into tears.

Besides, others are delighted to see us. With our hiking boots and safari hats, we create an exotic and amusing diversion for the youngsters charged with watching the family herd of goats, sheep and cattle.

As they smile and greet us with a bemused “Jambo!” Pete confirms my theory: if you dropped us in the middle of the bush and an eight-year-old Samburu child in an even more remote location, the kid would be home before dark while we would be a few links down from our accustomed spot on the food chain.

The Samburu have an understanding of and relationship to nature I could not have imagined or even thought possible. I look at the side of a mountain and see the beautiful striated outcrop of rocks, the varying hues of green vegetation. The Samburu look at the same mountain and spot a tree useful for making a toothbrush, a plant that’s good for soothing a nettle or bug bite. They know every track and how fresh the animal dung is—and whether or not a prospective campsite is safe.

On my first trip here two years ago, I watched in amazed confusion as Lemongas, one of Helen’s trusted elders, had a “conversation” with a honeyguide. The small gray bird lingered long enough to convince me that, yes, he was listening to Lemongas’s whistles. When the bird seemed to fly off in a huff, Helen explained that Lemongas told the bird he didn’t have time to get to the hive the bird had found.

On this trip, however, the honeyguide gets his way. Lemongas gets another visit from a feathered friend, disappears with him into the bush, and emerges 20 minutes later with his share of the dripping honeycomb.

Although the terrain varies a lot over the course of the week—from flat, sandy luggas to steep mountain passes–there’s a kind of rhythm to each day. It begins about 5:30 in the morning, when one of the Samburu team awakens us with his singing and a “good morning.” He pours water in the little canvas washbasin perched outside each of our tents, and we have time to splash water on our faces and come together for delicious Kenyan coffee and biscuits before we hit the trail. We’ll have a huge breakfast about two hours into our hike, consisting of fantastic muesli, homemade bread, and eggs with bright yellow yokes that tell you how fresh they are.

When we arrive at a new campsite at the end of a day’s hike, we have lunch and grab a mat from one of several dozen camels carrying them and the rest of our gear. By early afternoon, it’s hot and most of us are tired. We park ourselves under a tree for a “kip” as Helen and Pete’s team set up the tents, build a fire, dig the loos and create beautiful showers with makeshift “curtains” from brush they’ve collected.

As the sun goes down, we take turns at the showers and, one by one, arrive at the campfire for tea, snacks and cocktails before dinner. This is my favorite time of day. We recall the day’s adventures and tell stories as we watch the sky, undiluted by ambient light, reveal the planets and stars in all their varied sizes, brightnesses and colors.

You can’t help but be awestruck, sitting in the midst of all this natural beauty. However, the subject matter around the campfire covers a wide variety of “philosophical” issues, including how to maximize the staying power of the bucket of water you get to shower under every night—and whether it’s advisable to walk to the loo if you have to go in the middle of the night.

One morning, just before dawn, Dee announces she hears hyenas—reason #182 not to go to the loo in the dark, I tell myself. Besides, it’s much easier to water the land behind the tents.

We never, however, resolve flashlight controversy.

“Do you turn it off or leave it on?” somebody wants to know.

“Turn it OFF! It attracts bugs!” Mike answers.

“Yeah, but then, well, you’re out there alone, in the dark in…a vulnerable position,” I point out.

Any and all topics one doesn’t talk about in polite company move to the top of the list—and all them reduce us to peels of laughter and a level of maturity that would embarrass a four-year-old.

Clearly we are the most wonderfully good-natured mzungu ever to walk through these parts. As far as I’m concerned, that theory gets confirmed the night it starts to rain and we run around laughing in the mud as we struggle to pull our tent flaps closed.

On the trail, if we stop laughing and talking long enough, we can hear the Samburu team singing to pass the time as they guide the camels. One sunny and hot day we stop to rest in the shade and join in the singing. Before you know it, we are dancing, too. In that moment we all get the rhythm of the song, and even the camels seem to get the beat.

Everyday I continue to enjoy the camaraderie but cherish as well my growing ability to read the surroundings and see how they change based on where we are and what is happening overhead. The rain has left a treasure trove of fragrant sage, blooming cadia, yellow cactus blossoms. From atop the acacia trees, the weavers, hornbills, starlings and shrikes return our gaze.  Some of us, myself included, have learned the hard way to duck well beneath the acacias’ savage thorns.

I am also learning to pay attention to the lay of the ground—not just where to walk but what animals have come before us and to admire the work of nature’s architects, including the termites who create giant nests that look like pueblos.

And who knew dung could be so exciting! Less than 50 yards from one of our camps we see fresh elephant spore. Helen can hardly contain her excitement. It’s the first time in decades the elephants have felt safe enough to come to this part of Samburuland. The Milgis Trust, created to preserve the wildlife and fight poaching, seems to be having an impact.

We promise to stay quiet and try as well to tread as silently as Lemongas, who takes the lead. Walking in silence connects us more to what surrounds us and rewards us with a view of seven or eight elephants on the mountainside across from ours.

From our vantage point, we can also see grey sheets of rain, miles away in the mountains, and when we arrive at our next campsite on the Lomolok lugga, the team know this one may not be dry for long.

Then it comes. A rush of water, the runoff from the mountain rains begins to fill the lugga. Sometimes they can fill so quickly that the force of the water can be deadly. This one, however, is a nice peaceful stream, a welcome sight for the animals, four-legged and otherwise.

As the lugga fills, it strikes me as an apt metaphor:  For centuries outsiders have traveled here from far away and wreaked havoc. But maybe one day the little girl named Layla will be able to say that MEAK and its supporters poured a trickle of hope into this place far off the beaten path.

One of the great privileges of going to Africa is the opportunity of meeting some extraordinary local people who work very hard to make a difference and improve the lives of many. They refuse to accept the status quo and try to effect change. They often work tirelessly in the background, make things happen and they have very little time to promote themselves or their work to a greater audience.

Tanuja Walli from Mombasa is one of them. I met her during my last visit to Mombasa last February. I quickly realized that this very attractive unassuming woman was the local backbone of MEAK‘s pediatric heart mission in Mombasa.  Tanuja Walli left behind a career in fashion and with some concerned friends formed the Paediatric Support Group in 1998 at the Aga Khan hospital in Mombasa. Their mission was to help poor children suffering from congenital heart disease find proper and effective medical care. It became clear after talking to her that despite the very substantial contribution MEAK is making, there is still a huge need for more funding and local support.  I  thought then that I might be able to help by getting the word out to a greater audience. We sat down one sunny  afternoon and she told me how she came to be so involved in helping children with heart disease and she described her work.