Kenyatta National Hospital is an eight story, enormous maze of cement block walls that also serves as a teaching center. It took me close to half an hour to navigate my way from one end of the hospital to the taxi stand at the other end. Getting lost in the crowded halls and stairways is easy. The halls are bustling with medical and nursing students walking this way and that, and with visitors coming and going. There are constant throngs of visitors walking up and down the stairs, five abreast, and long lines waiting outside the accounting offices (of which there are many). Outside, the grounds are also crowded with waiting visitors and patients. Sick and weak people are regularly carried, or dragged in and out, with their arms around two family members.
The first time that I
visited the hospital I learned many disturbing facts: There are a large number
of abandoned children who live in the hospital, some of them have been there for
more than six years. Parents can’t pay the fees that would enable the child to
be discharged. In other cases, children with chronic or life threatening
illnesses are too much of a burden and the family does not have the ability to
care for the children at home. Many children with HIV are abandoned, and a
number with cerebral palsy and other tragic conditions, as well. They lie in bed
alone all day long, (I saw them) and no home or orphanage will take them.
Institutions don’t have the capacity to care for the children…they can barely
feed the healthy ones. According to the nurse who described the situation to me,
“It’s a nightmare.”
Aside from that, the hospital is dirty, lacking
the very basics (medicine, for instance) and in the pediatric wards children
sleep as many as three to a bed. The infant ICU has four babies in each
incubator and a wire basket in the corner where the dead ones are placed,
“waiting for transport.”
Emmah (from the International Child Resource
Institute) and I walked directly into the pediatric oncology unit without asking
questions or permission…I wanted to paint with the children. Ward 1E was
packed…60 or more children and lots of activity. I was surprised. The children
were all dressed in light blue hospital uniforms with 1E stamped in various
places. The ward consists of one very large room with cartoon characters painted
on the walls, and many beds, side by side (some of them occupied by miserable
looking children). There is also an ICU area and another room with large windows
all along one side, filled with small chairs and tables where about 30 children
were sitting and watching a cartoon video.
Some of them smiled warmly…some
had a large protruding tumor on their face…I had never seen anything like it
before. (Burkitt’s tumor, a hideous disease endemic to Central Africa and
responsible for 50% of childhood cancer deaths. It is characterized by a huge
protruding tumor of the jaw, maybe eight inches long and 4 inches wide,
accompanied by loosening of the teeth and protruding eyeballs…or extreme
swelling in the abdomen. Many HIV patients develop Burkitt’s. It’s not fair).
Kenyatta is the largest public hospital in the country and the only one that
treats childhood cancer. Many of the children arrive after it is too late to
save them. Nonetheless, the ward was open and airy with lots of light and it
felt surprisingly good.
that she was really interested in art therapy and she thought that there would
be interest among her colleagues. She suggested that I organize a lecture for
nurses and other staff about the benefits of art therapy to deepen communication
with the children. “That’s a great idea,” I said.
Herman, “Chief Public Relations Officer” in his large stuffy office with an
April 2006 calendar displayed above the desk (just one year too late). He had
the widest nose and thickest glasses I have ever seen. Herman is a BUREAUCRAT.
He could easily win first prize in bureaucracy if there was such a contest. I
think he should give seminars (maybe he does). As I talked animatedly about my
work, he sat behind his desk…expressionless. I imagined him thinking to himself,
“OK. I will have her fill out 50 meaningless forms and spend hours traipsing
around and meeting with 25 other important officials…that should be enough.” So,
he sent us to see the “Chief Nurse” who after sitting through a half hour
explanation of my project goals said, “I’m the wrong person. You must go and
talk with so and so.” We spent almost an entire day moving from one office to
another in that enormous building. Finally we spoke with the “Pediatric Chief
Nurse” a smiling, warm and sympathetic woman. We were told to return the next
day at 8AM with a letter written on letterhead describing the proposed lecture
and ongoing work with the children.
approved by many nurses and chiefs of various things and Herman himself, I was
ready to work. Ann, (my young Kenyan assistant) and I were given a tour of all
of the pediatrics wards, which ended up being an immense number. The pediatric
oncology unit is more or less hidden in one corner of the hospital, but the main
part of the hospital includes at least a dozen LARGE wards FILLED with children.
In addition, gangs of children in hospital uniforms roam the halls playing with
guns and airplanes made out of paper, laughing, and running around. Those
children seemed happy and relaxed and it appeared that they were free to wander
anywhere, running up and down the stairs chasing each other. I couldn’t make
sense of what was going on but I instantly fell in love with many of
them.
Once approval was granted, (I found this absolutely astonishing) nobody
ever questioned me again. I was free to do anything (similar to the gangs of
children roaming the halls). When I arrived at the hospital in the morning,
carrying bags filled with colorful art supplies, puppets, treats and other
surprises, I was greeted by large numbers of children who led me to a room or a
corner of a room where they helped me set up my materials. Every day we went to
a different meeting place. It was as though we were invisible…no one ever came
to observe or even pay us the slightest bit of attention. As the days went on, a
nurse would occasionally nod or smile in my direction, but I could have done
anything in that hospital. I really felt at home.
day following letter approval and Herman said that he would inform all of the
pediatric staff. He had already heard reports that people were excited and would
attend. When I showed up for the lecture, I had to check in with the chief Nurse
and other chiefs and then I was accompanied to the room (dirty) where the
lecture was scheduled to take place. The room, within one of the children’s
wards, was empty, except for two long tables and some benches and people were
beginning to arrive.
There were 22 nurses, including one male, and they all
worked in oncology or general pediatrics. They were an outstanding group,
desperately seeking any tools that would help them in relating to the children
they loved. Because there was not much time (they needed to return to work) we
started right in. After introductions, I asked them to paint what they love
about their work. “Paint what drives you, what makes you show up to the hospital
every morning, and then paint your biggest challenges.”
easy and they were quickly coloring with rainbow colors. After finishing, they
were hesitant and uncomfortable, looking around at one another. One of them
said, “Is this confidential? Will you share this with any of the other staff?” I
assured them that nothing would be shared with other staff and soon they were
busy expressing some very personal and touching material.
examples:
“I love when the patients are recovered and discharged. The parents
and the relatives are so happy. The big challenge is in the ward set up…broken
instruments, no thermometers or IV fluids or drugs, no working tools, no
hygiene. Parents and relatives are worried about their very sick child and I
can’t help. It is pathetic.”
"I love playing with the children as they are
getting better. The challenge is very sick children alone and crying for
help.”
“I like attending to the mothers who have come to the clinic with sick
babies and I make sure that they leave the clinic feeling satisfied that the
babies have been given medicine (if we have it) and good care. I hate seeing
mothers limp to the unit with tears rolling from their eyes because they have
just lost the baby.”
“It makes me very sad that the rich and the poor
(disadvantaged) still have to pay the same fees.”
“I love to see the clean
and smiling babies when they are feeling well. I love playing with the kids.
What I don’t like is the very ill, un-responsive patients. I also don’t like too
much the overwhelming work and I hate doing office tasks.”
“I am
dedicated to the children and I love them. My challenge is that we are 3 nurses
for 90 children.”
“What pleases me is when the patient is discharged and sent
home on treatments. What I dislike is when the baby has died and is in the
morgue.”
numbers of small coffins and crying relatives. After I heard the stories, I
stared at the nurses in disbelief and my hand reached out and grabbed the
nearest one by the arm. “How do you do it?” I asked with tears in my eyes. “We
help each other and we love the children,” she said to me. In that moment I saw
them all as angels with halos.
The workshop was about half over and a
five-year old boy, with the face of a Buddha, walked in by himself (the door was
open to the corridor and people were walking back and forth) and came and sat on
my lap. He stayed there for over an hour, until the workshop ended. I gave him a
little puppet to play with and he sat quietly snuggled in.
exercises in which the nurses drew childhood memories and I taught them some
basic exercises to use with the patients. They loved playing with the puppets
and doing role-plays. Next, I showed them my slide show of homeless and children
with cancer’s artwork. The group was silent and I was afraid that they didn’t
understand or worse, didn’t like it. I said, “You don’t seem too excited.” The
male nurse said, “It’s not that we’re not excited, it’s going deep in our
hearts. It’s very real.” He was crying. Another nurse said, “I’ve really learned
something…the drawings are a reflection of what is going on in the children’s
mind and heart.”
always carry my beautiful collection of puppets…African wild animals, children
of different races, doctors, nurse puppets and others. Throughout, the trainees
have fallen in love with the puppets (they call them muppets) and have begged me
to leave one or several with them. Until meeting the nurses I had refused…the
collection is really special to me. But with the nurses, that changed and I gave
them most of the “muppets” (I later gave the rest to the psychology students and
professors at the University). When I returned to California I was puppet-less
but inspired and in awe of the people who have so little and give so much of
themselves.
I also gave thousands of stickers, of every color and design, to
the nurses and to the children themselves. After the nurses workshop, Ann and I
left Ward 3A and made our way slowly to the other end of the hospital to look
for a taxi. As we walked, we were surprised to see children on every floor, and
running up and down the stairs…all with bright colored stickers on their faces.
Ann said, “It’s really spread.”
become my new special friend, held my hand and followed me everywhere. He knew
that he was my favorite and I repeatedly gave him extra treats and extra
attention (very wrong). I couldn’t help myself, although each and every child
that I met at the hospital was spectacular, kind, appreciative and wanting to
play and make art. I spent about a week working there, spread out on the floor
with groups of children who had sparkly stickers all over their bodies, and art
materials everywhere.
evening I told the psychology students about my experiences in the hospital and
I asked, “Is there a group of fifteen students who would be interested in a
practicum situation working in the hospital with children for a period of
six-months? You will be trained in-depth and supervised.” Out of 60 students,
every one of them raised their hand. Priscilla, the head of the department is
excited about the idea. So now, I have to return, because I want to continue the
work with the children and with the University students.
the plan is to start a puppet making business…find a group of women who can copy
the African animals etc. and add personal touches…the women will earn money…the
puppets will be sold on DrawBridge’s website (and other places) and they will
also be donated to schools, hospitals and orphanages in Africa. I love that
idea.