During her overnight shifts at Ronald Reagan UCLA Medical Center, nurse Millicent Manyore checks patients’ blood pressure nearly 100 times a week.
UCLA nurse Millicent Manyore extracts an embedded chigoe flea, known as a "jigger," from a baby's foot at a clinic she helped organize in her homeland of Kenya. Photos from Medical Missions Kenya.
But in Manyore’s native Kenya and other parts of the developing world, this routine test is virtually unheard of in rural villages and urban slums. So thousands of people with hypertension are never diagnosed or put on the simple medical regimens that can help prevent potentially deadly problems like stroke, heart disease or kidney failure that are linked to high blood pressure.
That’s one of the reasons why Manyore and a team of 14, which included nine people from UCLA, all paid their own way to Kenya to spend more than two weeks working in makeshift clinics in three rural villages and a slum outside Nairobi. Manyore organized the trip through the nonprofit organization she runs, Medical Missions Kenya, which uses volunteers to bring desperately needed basic modern medical care to her home country.
From May 31 to June 13, the group, which was composed of nurses, a pharmacist, two pharmacy students and two doctors, saw more than 850 people. The volunteers checked blood pressure and blood glucose levels, tested for malaria and HIV, taught proper condom usage, treated diseases and dispensed vitamins and medications. About 75 percent of the kids who came in had discolored patches of bald, scaly skin on their scalps — a fungal infection called tinea capitis, easily treatable with anitfungal medication.
"Coming from the place, I know how much health care is needed," said Manyore, who grew up in a village of 4,000 in central Kenya.
The need was so widespread that team members began their days at sunrise and often continued long past sundown, working by flashlight in rural villages without electricity.
"The Kenyans would wait for hours and hours and walk as far as 40 miles," said Manyore.
"They were so grateful and I just wish we could have helped more," said Alexis Davidge, a nurse in UCLA’s intensive care unit who volunteered in the clinic pharmacy, where team members worked overtime to fill the huge need for prescriptions.
The UCLA volunteers (from the left). Front row: Dr. Mark Sugi, nurse Cassie Yamaguchi, administrative assistant Nadia Popat, nurse Sherrie San Juan. Back row: nurse Alexis Davidge, nurse practitioner Elizabeth Robison who was already working in Kenya, Manyore, nurse Lauren Michelson, nurse Stefani Carson, nurse Fred Njau, nurse practitioner Michelle Kiprop, who is a UCLA alum.
Also from UCLA were nurses Sherrie San Juan, Lauren Michelson, Cassie Yamaguchi, Stefani Carson and Fred Njau, medical resident Dr. Mark Sugi and administrative assistant Nadia Popat.
For Manyore, the desire to bring modern medical care to her impoverished homeland took root in 1999, shortly after she moved halfway around the world to Kansas. During a routine physical exam, a blood pressure test revealed that she had hypertension — something she had never heard of, let alone been tested for, in Kenya. She also learned that she might have genetically inherited the condition, which prompted her to call her parents in Kenya and tell them to get tested. They did so, but it took two visits to the doctor, and her parents had to insist that the doctor perform the test. Her father, it was discovered, had extremely high blood pressure and was quickly put on medication.
The experience haunted Manyore, who found herself wondering, "How many other people are out there?" in a similar situation. That gnawing question led Manyore to nursing school at Park University in Kansas City and a job at the University of Kansas Hospital.
In 2004, when she went to Kenya for her first return visit, Manyore brought blood pressure cuffs and blood sugar testing kits to test her parents and seven brothers and sisters. Her brother turned out to be diabetic.
A patient whose feet are riddled with a Tungiasis infection called "jiggers."
Before she knew it, "100 people were waiting for me when I woke up saying, ‘I want to be tested, too.’" She was able to test only about 50 people before running out of supplies. Five of those she tested were diabetic, and 10 had hypertension. Unprepared to treat them, all she could do was suggest they see a doctor, knowing that, for most of them, this would be impossible, given the lack and expense of medical care. While Manyore continued to bring medical tests and supplies on subsequent visits to Kenya, she remained frustrated that she couldn’t do more.
In 2010, Manyore founded Medical Missions Kenya. During the organization’s first trip in 2011, a team of 12, including three from UCLA led by Dr. Allison Diamant, provided care to about 1,200 people.
"The benefits to the Kenyan people … you can’t measure that," Manyore said. "For the first time we were not just able to diagnose problems, but also treat them."
Encouraged by the success of that mission, Manyore knew she’d do another, this time with more volunteers from UCLA. Among the 14-person team who traveled to Kenya last spring was San Juan, a nurse who, with the help of interpreters who spoke Swahili and Maasai, checked vital signs and blood glucose levels, took medical histories and assisted the pharmacists in preparing oral antibiotics and filling prescriptions.
"Being a part of this experience changed my life for the better," said San Juan, who noted that before the trip she used to complain about "first-world problems" like going to a store only to find they didn't have the brand of bottle water she preferred. "This experience opened up my eyes to the important issues that exist across the globe. If I had the opportunity to participate in this mission again, I would do it in a heartbeat."
Boys soaked their feet in an antiseptic 20 minutes to kill the parasites prior to removing infected tissue.
One of the most vexing problems the team worked on was "jigger" removal. Jiggers are parasites that embed themselves in people’s feet and turn into painful skin growths that can be fatal if left untreated. These parasites thrive in places like Kenya where people walk barefoot on dirty surfaces because they cannot afford shoes, so although the volunteers could treat them while they were there, the people remain vulnerable to future infections.
The trip ended with a two-day safari. But even during this brief "vacation," the medical team continued to see patients: People who worked at the hotel where they were staying asked to be examined — "their only chance," Manyore said, "to get this kind of treatment."
Manyore is already preparing for the organization’s next trip, in April 2014, when she plans to transport as much baby formula as she can. During the recent trip, she recalled, a 13-year-old mother brought her baby in with an eye infection. The baby wasn’t moving during the examination, which panicked Manyore until the UCLA physician on the team, Dr. Sugi, diagnosed the problem as a lack of nourishment. They used a bulb syringe to squirt liquid vitamins into the baby’s mouth and the baby revived.
"I will never go on one of these trips without some sort of nutrition again. That baby could have died," Maynore said.
People interested in volunteering on the next trip should go to the Medical Missions Kenya website.