It has been nearly two-and-a-half years since I first visited Eldoret, Kenya as a senior resident in internal medicine & psychiatry at Duke University. I had never traveled to Africa, let alone done any global health work in a developing country. During my three months in Eldoret, I did some of the most meaningful work of my entire residency training with AMPATH at Moi Teaching and Referral Hospital (MTRH). I treated patients on the brink of death everyday, saw forms of suffering I never fathomed were humanly imaginable, and experienced love and faith in a new light.
When I arrived this morning in Eldoret it was reassuring to see the same basic welcome sign that had greeted me at the small airport. As nice of a "welcome" as it was, it was palatable as I walked off the plane that things around me had changed. On the drive in, new buildings, new hotels, new hospitals, and a bustling in downtown that seemed more frenetic and expansive.
Of the changes however, once seemed to strike me the most. It might seem mundane to those reading this, but for me it was huge.
Working with AMPATH and Duke in Eldoret means that you live in a compound of houses lovingly referred to en-mass as"IU House." Every day the medical students, residents, pharmacists, and attending's walk from IU House to MTRH to round in the hospital, treat patients, perform surgeries, and delivery babies. And every day, in general, the path, the walk, the steps you took to the hospital were along a maroon clay path. A dirt trail along a pot-hole strewn road that when it rained became a muddy, slip-slide, of a walk. I fondly remember trying to navigate the best "off path" steps to avoid some of the deeper sink holes of mud, only to arrive at the hospital with a layer of clay below my boots that required several minutes of scraping to remove. The mud and clay of the trail would leave your boots stained, your pants and slacks colored, and was a badge in some ways of the trek to help patients on a daily basis.
Thus, when I left IU House today for my first walk into Eldoret, I was shocked to see a paved sidewalk where the dirt path used to lie. I just stood a moment and marveled at its simplicity.
I knew coming back to Kenya would be different the second time around. I think mostly because I am different. I became a father. I completed residency and worked as faculty for a year and then I began the most emotionally challenging year to date, as a palliative medicine fellow.
I anticipate many more changes, and many more differences on this new journey. And, I appreciate this new change, because in the end, a paved road during the rainy season is a sight to behold.
