Lakshmi Jain wrote this during the unrest around the Kenyan elections, in October 2017. The nurses' strike has since ended, and Jain is still working for MSF / Doctors Without Borders in Homa Bay ...

My introduction to Homa bay county hospital as the new HIV doctor has been at a time that the local health system has been under immense strain.

The doctors in the public hospitals had previously been on strike last year for over 100 days. Currently the nurses are on strike, this has been going on for four months now.

Despite the hospitals not working as they should, the chaotic electioneering period has made things even more difficult. Protesters often clash with the police: the end result being mass casualties. MSF has been providing staff and other medical support.

Surgery and obstetrics has been the worst hit and many general physicians are covering all services.

I arrived in Homa Bay in October where MSF currently support the local ministry of health hospital. MSF are specifically supporting the inpatient medical department. There is a huge burden of HIV disease in this area and patients often arrive in the late stages of infection.

As a result of the strike I have found myself looking after paediatric TB/HIV patients as well as adult medical patients. I often feel a pang of guilt as during the strike I have had some great learning opportunities. I would never see children in the UK as I have been trained as an adult physician. My guilt comes as I ponder over whether I really am the best person to care for them, my training hasn’t really equipped me for this. In reality, there is no one else to step in and so with little alternative I stop indulging my concerns. MSF is here to cover the gaps.

Read the full article about fighting HIV in Kenya by Lakshmi Jain at Doctors Without Borders.