WAPELLO, Iowa — Alana Poage, Louisa County’s public health administrator, is preparing to leave for her third mission trip. She has already been to Ireland and Kenya to help, learn, teach, share and bring home new insights.

Beginning Dec. 13, she will spend three weeks in India with Global Volunteers, teaching about public health, helping with immunizations and doing clinic work.

When she was with Global Volunteers in Glen Cree, Ireland, the job was one mostly of physical labor such as painting, cleaning, cooking, refinishing and generally helping with upkeep.

More recently, she spent four weeks in a village in the north-central highlands of Kenya, working in a hospital.

Poage, 60, has been a nurse for 26 years. She was able to go to Kenya as a member of the International Short Term Volun-teer Program of the Medical Benevolence Foundation, an affiliate of the Presbyterian Church USA.

“It is an amazing opportunity to do medical mission work in an area where resources are scarce and the local health-care providers thirst for new information,” Poage said.

Poage was assigned to work at the hospital in Tumutumu, a village so small that it’s not even shown on maps.

It was winter in Kenya, with temperatures of 40 to 50 degrees. One of the first things she noticed was that many of the local people, most of whom were members of the Kykuyu tribe, the largest ethnic group in Kenya, were wearing sweaters but no shoes.

The major road in Tumutumu is one lane of dirt or mud. Typical two- and three-room houses are made of limestone because termites make wooden homes short-lived.

Most Tumutumu families live on farms about the size of an average yard in Wapello. They are subsistence farmers, growing enough maize, potatoes and beans to feed their families year-round.

“If they are lucky, they might have a macadamia tree that produces a cash crop,” Poage said. “And if they have more land, they some grow tea or coffee.”

Poage said there are many bananas, melons, passion fruit, papayas, tangerines and similar tropical fruits grown in the area and something called ground nuts, which are similar to peanuts.

Often, ears of maize, which is similar to Iowa’s field corn, are roasted over charcoal-heated kettles and sold for lunch.

Since Kenya was once a British colony, its residents follow some British customs such as taking a tea break — drinking a cup of tea and eating a biscuit or bread and butter sandwich each morning and afternoon.

There is also a food called porridge that is made from a root similar to a turnip. It turns purple when cooked.

“It doesn’t have much taste,” Poage said. “But it is very filling.”

Health care

She also noticed that most of the Kenyans have good teeth — they don’t eat a lot of sugar. But they eventually lose their teeth if there are any problems because there are few, if any, dentists.

The Tumutumu Hospital, which is owned by the Presby-terian Church of East Africa, is open to anyone.

“The staff is very deeply religious, with a strong Christian ethic,” Poage said.

No one is turned away. However, patients can get only the services they can pay for,

she said.

If expensive tests are called for and patients can’t afford them, they get a hands-on assessment, for which the staff is quite skilled.

There are nine wards in the hospital. A government program for children is available, but requires treatment at a larger town about 40 kilometers from Tumutumu and transportation is scarce.

“When I was there, there were 19 children hospitalized with HIV and malaria — the two most-common diseases. Both can be prevented and treated,” Poage said.

“What disturbed me most is that the children are so ill and dehydrated when they are brought to the hospital, that IVs can only be placed in the jugular vein. That is not done here and it is very difficult to watch.”

In the main ward, there are eight beds. The mothers sleep in the beds and take care of the infants.

Sad news

Poage was saddened to receive a letter recently that one man, Joe Wanjohi, had died after 49 years as a patient at Tumutumu Hospital. He had birth defects that left him blind and distorted all his limbs so that he could not walk or even feed himself. Because of his disabilities, his parents couldn’t care for him and the orphanages would not take him, so the people at the hospital more or less adopted him as a brother. Poage said Joe always had a kind word or gentle thought to share.

“He was greatly loved by everyone and will be missed tremendously,” she said. “He had a memory like a steel trap and could recognize a person’s voice after being introduced to them only once.”

‘Delightful’ youth

The natives in the Tumutumu area generally speak three languages: English, the Kykuyu tribal language and Swahili, the national language.

While there, Poage visited schools with community groups and talked about AIDS to sixth- through seventh-graders.

She was surprised at how straightforward and honest the children were with questions.

Notebooks were made of old paper that had been bound with needle and thread, she said, yet “those who had books were so proud.”

She describes the children as delightful, polite, intelligent and quick.

Other wards in the hospital included a women’s surgical unit, men’s surgical unit, a gynecology unit, maternity unit, a women’s medical ward and men’s surgical ward. The smallest ward had four beds.

Poage also did some home health care in the Tumutumu area.

“They have the same health problems we do,” Poage said. “They don’t have access to the equipment we do. Without it, some procedures are much more risky.”

Simple survival in towns like Tumutumu is risky. They don’t have electricity. There is no running water. They use pit latrines. War and AIDS in Kenya and its surrounding countries have taken a toll and created many orphans.

“It is such a different culture,” Poage said. “The people there are kind to each other. There is such gentleness. They share what they have and if they don’t have anything, they will offer their time to help or pray for you. It was a blessing to meet and work with the people at Tumutumu Hospital and at the end of the journey I felt that I was the one who received the greatest gift.”

Reporter contact information

Connie Street: 319-527-8164

ckcasey@louisacomm.net