Kenya Day 3: Screening Day

At 6:30 AM, roosters began crowing across the village, cutting through the early morning before the sun had fully risen. The sound traveled easily, layered and persistent, signaling the start of the day well before alarms or schedules.

We gathered for breakfast after a full night of sleep. The meal was generous: potato sauté, papaya, bananas, mixed vegetables, plantain stew, beef sausages, boiled eggs, mandazi, and Kenyan tea. People talked briefly through the day’s plans before heading out to the trucks for the drive to the hospital.

By 9:10 AM, we arrived at Nyamira County Referral Hospital in trucks loaded with medical equipment, luggage stacked high in the beds. As we entered through the gate, patients were already moving through metal detectors into the courtyard. Some arrived alone; many came with family members who would remain with them throughout the day.

One of our drivers, Dennis, introduced me to a group of patients waiting together in the shade of a tree. I thanked them for coming and told them how honored we were to be there. They responded with smiles, and drew close for group photos.

Inside the Hospital

At 9:55 AM, hospital staff led us through the facility—maternity, laboratory services, radiology, women’s and men’s wards, and the operating theater. Patients watched as we passed. Some waved. Others observed quietly. Staff members moved steadily between rooms, focused on their work, pausing occasionally to answer questions or give directions.

In the maternity ward, we were told the hospital delivers an average of ten babies a day, even as preparations were underway for an influx of surgical patients.

By 10:50 AM, doctors began seeing patients. The morning unfolded with a mix of planning and adjustment. Language barriers occasionally sent patients to the wrong room, but staff and volunteers were diligent in resolving the confusion quickly. Everyone eventually reached the correct place.

Billy distributed numbered tickets, and patients settled onto benches, watching closely as numbers were called. Some members of our team worried about how long people were waiting, but local staff explained that waiting was expected—and that patients were grateful to be seen.

While screenings continued, volunteers unpacked and organized medical equipment. Instruments were sorted so surgical teams could access them efficiently when operations begin tomorrow.

The waiting areas filled gradually. As individuals were called into offices, others slid along the benches to make room. Many patients had dressed carefully for the day: pressed shirts and sweaters, coordinated skirts and tops, scarves draped over shoulders or wrapped around heads. Men wore polished shoes, slacks, and sport coats. One man in a ball cap watched and waited quietly, a cane and water bottle resting in his lap.

Patient Encounters

At 1:00 PM, Vincent arrived to be evaluated for a cyst on the left side of his neck. It has been present for two years and he thinks it may have developed from shaving. Vincent said the pain is manageable, but he would prefer to have it removed. He traveled approximately 20 kilometers by passenger car with a neighbor. His wife stayed home with their four children, all of whom are in school. He hopes our team will be able to help relieve his discomfort.

Screenings continued throughout the afternoon. Some patients had not been fully screened locally, which meant surgeons occasionally saw individuals who needed medical rather than surgical care. As the day progressed, processes adjusted and the flow improved.

Byron, a local resident and Billy’s brother-in-law, was present both as a patient and as a liaison. He helped explain the recent transition from NHIF (National Hospital Insurance Fund) to SHA (Social Health Authority). The change has created challenges for many patients, including gaps in coverage visibility, digital access barriers, and delays in reimbursement—particularly in rural areas. For some, the transition has made accessing care more uncertain and more expensive.

One of the most striking moments of the day came when Truc Au, a member of our team, helped a young mother breastfeed her infant. Covered in oversized clothing, the woman appeared visibly undernourished and exhausted. She struggled to lift her child to her breast. Truc assisted quietly—supporting the infant and helping position the mother more comfortably. The woman was there to see Dr. Augustin for a goiter and is scheduled for surgery tomorrow.

Another patient, David Umbiri, arrived with his wife, Uniha, who was there for moral support. The two met at a wedding many years ago and married in 1980, and after nearly 46 years together, their ease with one another was unmistakable. They spoke readily, smiled often, and seemed genuinely glad to be together in the waiting area.

David has lived with an inguinal hernia since July of last year and was seen today and booked for surgery. He shared that he completed four years of schooling and lives in a traditional thatched-roof rural home, but he arrived carefully dressed in a blue plaid shirt, light gray blazer, pressed khaki pants, and dress shoes. He carried himself with quiet confidence—matched by the warmth he and Uniha showed to everyone they met.

At 3:45 PM, Emmah (18) arrived with her young aunt, Elvin, who hoped to be evaluated for varicose veins. While we are not equipped to treat that condition during this trip, both women immediately offered to assist as interpreters for the week. Elvin begins helping tomorrow morning.

Closing the Day

As the afternoon continued, registration areas remained busy. Several gynecology patients had been unintentionally deprioritized during intake. Traci persisted, working with volunteers and interpreters to ensure those women were identified and seen.

Later in the evening, Sheila, a hotel staff member, escorted some of us through the markets of Nyamira. She explained that market days are Fridays and Sundays, and that women traditionally carry kiondo bags—woven, colorful, and widely used. As we moved through the crowds, she told us, “I wish you could hear what everyone is saying. They are so excited you are here.” The streets were lively and welcoming, especially as the workday ended.

Back at the hospital, Dee, Sarah, and Sherry worked carefully to organize the operating room schedules, reviewing cases and adjusting plans well into the evening.

Dinner was served at 7:00 PM: ugali, rice, brown chapati, pan-fried chicken, green gram curry, vichy carrots, and creamed managu. Billy thanked the team and spoke about how appreciative the community has been. Tomorrow’s surgical schedule is full, beginning promptly at 8:00 AM.

The day closed with a sense of readiness. The screenings are (mostly) complete. Tomorrow, the work continues.