Volunteering in Kenya

Smiles Transcend Cultural Boundaries

Have you every smelled the odor of waste burning on the side of the road?  Have you ever seen women and children carrying loads of firewood or five-gallon buckets of water on their heads for distances of a half a mile or more? 

How about seeing a jail cell made from a ship’s metal cargo container where prisoners are placed after sentencing?  They stay there in the sweltering heat until they have done their time or until they die because they are not cared for by the local police force.  Their families must feed them or they simply do not eat.

When was the last time you saw women and children digging holes for water in a dried riverbed?  Sometimes they must dig to a depth of fifteen feet before reaching water.  Have you seen children so hungry and malnourished that their stomachs are distended?  Can you imagine living in a place where infant mortality is 40% or feeding your child his only meal of the day just before bedtime so he can go to bed on a full stomach?  These questions paint a picture of cultural anomalies and a place that few of us would ever want to live.

This past October I had an opportunity to go to that place with eight other men on a humanitarian/construction mission sponsored by my church.  I visited a very small town located in Kenya – called Kakuma, which is about 80 miles south of Sudan in East Africa.  We built a cinder block structure that will be used as a training center and church for the local people, many whom are in a refugee camp separated from their homeland.  Riverside Regional Medical Center graciously donated a large amount of medical supplies for me to take and use as needed.

I was in Kakuma for two weeks and what I witnessed has been engrained into my consciousness. I think about the sights, sounds, and smells every day.  I think of the people and the way they looked at me and fondly remember how they would look at my silver/white hair and laugh – not because of a bad haircut, but because of the color. 

I couldn’t speak the local languages, which were Swahili, Turkana, Dinka, and other dialects that incorporated a little of each.  I have never been in a situation where I was at such a distinct disadvantage.  However, there is something that breaks the barriers caused by language and cultural differences. It’s called a smile and conveys a message that words often do not.  It shows acceptance and openness to someone else.

I used this method of communication when I treated one young girl, the Tribal Chief’s daughter, who had an infected ulcer on her ankle.  I treated and dressed it every day.  The first day she was very hesitant, almost afraid.  Her culture had taught her to be afraid of white men and that she must behave or the “white man would come and eat her.”  She spoke no English, and I needed an interpreter.  A smile was all it took to change her hesitancy into acceptance.  Her countenance brightened each day that I saw her.  I can still see her in my mind’s eye happily leaving the camp with the candy I gave her.

One day during my visit, I asked a woman what it was like to have so many babies die in infancy.  Her reply was, “When one dies, another one is born.”  In America our culture does not allow us to understand that statement.  We smiled at one another and went our separate ways.  I did not know what else to say.

As a result of this trip I now realize that we see cultural differences every day while taking care of our patients.  We never know how our body language and facial expressions will affect those individual.  So remember this, a smile is simple and sometimes is all it takes to transcend cultural boundaries.

Thomas Keithley, MHA, BSN, RN

Administrator, LTACH, Hampton Roads Specialty Hospital, Riverside Health System


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Click here to view story pg. 2 in book.