On our first day we received the visit of the director of the hospital, Dr. Patrick Nyaga, in his Sunday best together with a baseball cap and accompanied by his 7 year old child. He greeted us, and as we were having lunch with him at the dining room of the place (an awful meal!) he explained to us in general the planning for our work in the Gatundu district. This is a small village with hardly a handful of shabby buildings along the road that goes through them, at about 70 Km North of Nairobi and belonging to the Thika province. The hospital, at which we arrived at 7 am the next day is an outdated building of British design with several one-plant pavilions along a dusty, yet well-kept with gardens along which we went with the woman head of infirmary, superintendent and factotum at the hospital, the efficient and charming Betty. She showed us the hospital rooms, and she took us to the place for our work and future operation theatre, the only one in the centre. This was a shabby old room, and we settled in it at once. We took out our instruments, and we added a second table while we observed the noisy respirator. We were warned we would have to share it with urgencies, chiefly Gynecology (there were daily 3 or 4 caesareans), another limitation after the one of having only one electric scalpel. Still, those difficulties did not hinder our work at a good rhythm, giving all the possible time to it, since we left the hotel at 6:30 in the morning with the first rays of the sun, and coming back between 20 and 22 hours, in full night, since days and nights have the same length in those latitudes. Sunrise and sunset are fast, as if the sun would go faster, thus taking time away from loving couples in their evening walks.

We performed 5 operations on 50 patients, 7 of whom were children between 2 and 10 years. Most of the cases were inguinal and umbilical hernias, some very large, and we had several complicated eventrations which took a long time, someone up to 4 hours. (For more details please see the data base in Exel where all data and tipe of operation for each patient is explained. They brought us our lunch to the waiting room before the operation theatre, and it was always the same: aluminum containers full of rice, green potato sauce and boiled old meat, and we duly eat out of need and courtesy. At the beginning and end we saw the patients to be operated the next day and those already operated upon which needed hospitalization, chiefly those who needed drainage. When we left, we still had to leave two or three without being operated, but we fully trusted our local colleagues and had given them the proper instructions.

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We always felt well accepted, and the medical staff collaborated very well with us. We have to praise specially the commitment of the anaesthetists Veronica and Jennifer who put up with the additional hours we requested, far beyond their timetable, helping Beatriz who, with halothane for the general and the fine needle for the spinal anaesthetised all the patients we operated upon and helped with the urgencies. Our commitment extended itself to formation teaching for students and doctors at the hospital, so that a handful of them helped in the operation theatre and in the waiting halls. I want to single our the work and the enthusiasm of the young surgeon Dr. Abdirashid, a very valuable person with a great interest in learning, who even, under the direct supervision of David the direct supervision, an inguinal hernia. In the same way we have to give special thanks to doctor Makena for her collaboration with the patients and to Janet, head of infirmary, for her patience and skill. We had also prepared a few talks or conferences, but we could not give them for lack of time, as, I have already said, the daily work took up the whole day (and part of the night).

This hospital, so out of date and in poor shape, has only a short time to go, as the China government has financed the construction of a new one by the side of the old one still under construction. It is a white building of four stories which will be inaugurated next month. We had the opportunity and the privilege visit it, while none of the doctors there had seen it yet. Betty showed it to us, and we had to go through a side door, fully locked and watched by Chinese guards, as it is the only one of its kind in the place. It is furnished with all advance techniques, and it is said to be a copy of Cantonese model. The operation theaters are computerized. The change to a less toxic gas as the insofluorano for anaesthetic induction, the room for childbirth, the Intensive Vigilance Unit with 14 beds and 2 isolated, the lifts with a memory, and in general all the furniture and materials spoke of the latest technology and implements. We noticed that all titles were written in large Chinese characters with their name in English below. (It’s a pity Swahili, which is the local language spoken by all, has been ignored. Curiously, Swahili has the same vowels as Spanish and is pronounced in the same way. The is very significant as in this way all the natives who share English as official language begin to learn it in the school, so that their pronunciation is very similar to that of a Spaniard when he dabbles in the language of Lord

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Byron, and that helped our mutual understanding). In this way all future campaigns in Gatundu will have excellent installations in the new hospital.

We also had our leisure time on weekends, and we made god use of them to arrange for two excursions, very expensive by the way as it was high season, which took up all our summer extra pay. But who could miss watching wild animals while in Kenya? Coming here and missing wild game is like coming to Madrid and leaving without visiting the Prado Museum. On our first Saturday we went to see the Nakuru lake, famous because hundreds of thousands of flamingoes used to fill its waters and adjoining fields as an infinite mantel made out of feathers like a Rotko picture, who, when all together would take flight you would feel like being below the rose-tainted umbrella of Mary Poppins. A unique show without comparison, which the writer of these pages enjoyed many years ago and now lamented that his companions this time could not share. There are no flamingos any more. The all have flown to better waters in lakes up North. On the other hand Kamunge, our guide and daring driver of the old jeep, managed to show us two rhinoceroses, a lioness and a number of other wild animals. The best show was reserved for the end when we were taken to visit the Masai-Mara reserve. After a seven-hour trip, including the time needed to change a tyre that burst on the bad road, we arrived at the Sarova Hotel in the Mara Game Camp inside the reserve itself. A luxury hotel with bungalows as tents as imagined by any tourist or any reader of “Out of Africa”. We had a two-and-a- half day safari in a large Land Cruiser till the Tanzania boundary, and we visited the rest in photographs. We saw sleeping leopards, herds of buffaloes, giraffes, elephants, monkeys, gazells, hippopotamuses in the Mara river… and we watched a family of lions eating out the unwary cattle that fell to their claws while vultures were seen patiently flying high around the scene waiting for the lions to leave and feast on the remains.

Thus we left a country, taken up by the atmosphere of its landscape and the friendship and hospitality of its people. Kenya is a nation of great contrasts, a typical third-world country where modernity is side-by-side with tribalism, development and intelligence with apathy and misery.

We believe our campaign was fructiferous, with many patients operated upon, with a bit of teaching, and memories we shall never forget. We have all worked as a team. “Cirujanos en Acción” is an

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