I am driving in our car, the gear stick has been getting stiffer and stiffer, I find myself driving in second gear for as long as I can bear the high revs screaming back at me, I come to the very bumpy part of the road and have to drop into first gear, as hard as I can I push the clutch into the floor hoping the gear stick will move, my teeth are being worn down as I grit them each time I try to change gear, eventually it submits and we carry on.
Lucas is in the back and merrily chatters “tuk tuk, tuk tuk, moo moo” as he spots the passing scenery. We come to a tarmac part of the road and I gain some speed but as soon as I push the break pedal down, it decides to ignore me! Eventually the car slows in time but I realise that this car is not feeling very well. I gently continue home in first gear being overtaken by people walking the same stretch of road to avoid the need for any quick brakes, I am so thankful to be safely home. We decide its high time we see a mechanic. Andrew takes the car down to the garage at snails pace, expecting the worst and at best an expensive new clutch and breaks. Later that day the mechanic phones us, 4000ksh/£30 for replacing the entire break system, a new clutch cable and steering fluid…….we are relieved and the best bit is the cars drives so well now! Better then ever.
Our car really made me think how many people here view healthcare. Any treatment comes with a cost and like us with the car we put it off and off until the car does not function and is unsafe before we got it checked out and fortunately fixed. Healthcare for many seems the same here, when people begin to become unwell, they hope they are not and carry on, then they realise they are and they ignore it, eventually they are unable to work or function and they are pushed to the point of seeking help. Like us with the car, they have no idea how serious it might be and to make this worse treatment is not an option if they are unable to afford the transport and hospital fees. Understanding it from this perspective helps me see how so many people can present with advanced illness slimply through fear of how much they may have to sacrifice just to get to the hospital. It’s a different world we are living in.
Andrew has spent more time in the hospital recently as we await resolution on the slit lamp. He has often come home shocked at the lack of support the staff have. There is one ophthalmologist in the hospital (which is the only public eye care unit for 1.6 million people) who is off for the whole of December and is rarely present when not on holiday. This leaves the eye unit run by non-doctor staff who are very able but so over worked and under supported that unfortunately it seems the majority of patients are not getting the correct diagnosis or treatment. This is so hard to witness when some have travelled so far only to leave having spent small amounts of money they do have on treatment that will not work.
We have decided rather than pick fault at a system which is clearly not working, whilst we can, we will do our best to support the staff in a way that will hopefully have a longer term impact. The temptation for Andrew is to get stuck in seeing the queue of patients but this is simply pouring water in to a leaking bucket. We have now decided to establish a regular teaching sessions to provide the team with knowledge and long-term skills to equip them beyond our time here. It is not going to be easy so it is lots of role play (encouraging staff to talk to the patients rather then just shine a torch in their eyes), practical sessions and interactive teaching. It’s great for me, my wannabe Blue Peter presenter skills are all being used.
My macho man is of course my beautiful husband, but not because he came to save me when the brakes failed on the car but in fact because it translates from Kiswahilli in to my “Eye man!” We finally started Kiswahili lessons this week and “Macho” means “eyes” much to our amusement! Lucas is getting to grips with the language and knows where his nose, eyes and ears are in Kiswahili! We had fun today as he impressed a waitress as he pointed out Kenyan animals she asked him in Kiswahili!
After feeling so gutted last week, we have been amazed by the support offered by family and friends (you guys!). The support of the guys at the International Centre for Eye Health in the Tropical School where Andrew works has been amazing. His supervisors have been so helpful and the head of department has incredibly generously lent us her slit lamp ear marked for a now delayed project in India. Andrew and the team, especially Jyoti (amazing) have been working really hard to get it sent out next week. It is over 80kg, big and expensive and the customs system here is still to be navigated through.
Andrew and Stew (app designer) have been working really hard to make the apps for the phone tests smooth and more useable… I tell you I’m glad I’m not a computer programmer… it’s a long laborious job and Stew realised by the end of this week he had not left the apartment for a full 6 days but the outcome is looking great and we are all very excited at the potential this has.
I’m not really sure why I made macaroons this week, probably because I’ve always wanted to and I felt in what has been a challenging time I wanted a challenge to conquer, also with the disappointment of last week these chocolate almond meringues certainly helped!
We now also have our rosemary mini Christmas tree… it is not quite what we are used to but it smells nice!
Recipe – Chocolate Macaroons
Ingredients – macaroons
50g cocoa powder
400g icing sugar
225g almond paste (we don’t have any of this so I ground down almonds)
250ml egg whites
Ingredients – ganache filling
100g dark chocolate
140ml double cream
20g cocoa powder
40g unsalted butter
1. Pre heat the oven to 160°C.
2. Sift together the cocoa powder, ground almonds and sugar.
3. Beat the egg whites till they start to peak. Whisk in the sugar.
4. Gently fold in the sifted ingredients.
5. Put the mixture in a piping bag.
6. Pipe small rounds on to a baking sheet, I also used a silicone mat both worked well.
7. Once a tray is piped bang the tray on the surface to remove any air bubbles and leave for 10minutes to form a film which then makes them more shiny.
8. Place in the oven and bake for about 10 minutes, they should lift cleanly off the mat/baking tray, cool on a wire tray.
For the filling:
1. Bring the cream to the boil over medium heat
2. Gradually add the chocolate to the cream, beating it with a whisk as you do so. Continue till all the chocolate has melted and formed an emulsion
3. In a separate bowl stir the water and cocoa powder together till smooth. Add the unsalted butter to the bowl and combine until smooth
4. Add the chocolate-cream emulsion to the butter-coca mixture, combine until smooth.
5. Fill the mixture in to a piping bag
1. Sandwich the macaroon halves together with the ganache in the middle.
2. Serve with hot cups of tea – delicious!….macaroons conquered!