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Thursday, December 9, 2010

Project Contact - Sam Richard MD

I first met Kermit after he was asking for volunteers for Project Contact on his radio show, I think it was 1995. I’m not much of a basketball fan, but did know him from this Portland Trailblazer days. In the early 90’s Kermit and Michel Thompson had an afternoon radio sports talk show that I loved to listen to on my drive home from work. The show was a real conversation. The two played well off of each other, being witty and humorous with interesting things to say. The show was about sports but also so much more. Much like “Car Talk” on NPR, about cars but not really. The manager that broke them up made a terrible decision to separate them. Neither one was the same alone. Even my wife Julia who only considers something a sport only if it takes place on top of a horsed listened to them. I haven’t listened to sports talk radio since. Sports talk radio is just a bunch of screaming adolescents these days.

We started having meetings in the back room of Kermit’s sport bar and restaurant, Le Slam. Beside myself there were a few others who have been there since the beginning like Jay Donkers. We gathered medicine samples, other necessary medicines and supplies for the trip and talked ourselves into the adventure.

Our first trip was to the slum of Kibera. This slum was the local for the movie “The Constant Gardener” if you want to know what it’s like. We used this poor rudimentary school, which consisted of a dirt and weed courtyard, surrounded by corrugated steel roofed lean-tos with packed dirt floors. The school desks and benches were crude; there was no electricity, no running water or plumbing, just a hole the ground out back that really stunk.

The wonderful people of that slum more than made up for it. The kids were bright, respectful, and despite being ragged and worn, their uniforms were neat and clean. So much different than the average entitled American patient (except of course my wonderful patients). The adults came in their best. There were sick people where with just a touch of our- take for granted American medicine really make a difference. No one came in just for pain pills they were looking for treatment. I remember a subsequent trip where a poor widowed woman came in acutely ill and near death. She made her living as a prostitute, there’s really not much else to do in the slum for a woman with no skills. Her husband had died, probably of AIDS. She was weak, malnourished dehydrated and febrile and had come in because she could no longer work. She had pneumonia. But with no money, even if we could get her to the hospital she wouldn’t be able to afford the antibiotics and IV’s. I gave her some IV fluids and a dose of a common antibiotic. I thought I was sending her home to die but planned to see her back the next day for more treatment. There was nothing else we could do.

The next day that woman walked in beaming under her own power. I could hardly recognize her; Kermit had to point her out. Little did everyone know or believe how lucky she was. I think she had pneumococcal pneumonia where just a bit of the right antibiotic at the right time can give a miracle. It made me look like the Great White Doctor. I wasn’t a great or even good doctor. I just had the right medicine. It is more important to have the right resources in the right place. A mediocre doctor will do the right thing.

Back then we always stayed at the place called the Methodist Guest House. It is actually more like a minimum-security prison. Gates with guards, walls with sharp broken glass imbedded on the top, ironwork on all the windows. It’s a place where missionaries stay on the way to go and do well and give credit to the lord. We always kept a low profile there. Project Contact didn’t want your soul and allegiance; we just wanted to be in a place where a little help, either through medicine, education or food might just give you that little boost to a better life. At that time I was working for the Department of Family Medicine at Oregon Health and Sciences University. They had recruited me to start a community clinic for a place to train their residents. I convinced a couple of my residents to come with us on the next trip. One of them was Theresa Gibson MD who has been instrumental in the growth and vision of Project Contact. Theresa is a gifted and beautiful woman with a personality to match Kermit’s (I take great enjoyment in listening to them complain about each other). The medical staff realized early on that just showing up three or four times a year was a good thing but what we really needed was an ongoing presence.

While maintaining the street clinics Kermit was able to get a building built in one of the other slums named Kwangare. Over the years Project Contact’s home, The Ray of Hope Clinic has grown to have a pharmacy and laboratory (thank you Ron Artest), a clinic delivering primary care, immunizing children, testing for HIV, and delivering babies. It does a lot of good for the population there. Kermit has also established an elementary school for kids who just can’t get into a regular school. Maybe too poor, developmentally delayed, or homeless without a sponsor or guardian. About 50% are HIV positive. Project contact provides the teachers, the books and study plans, the uniforms and hot lunches daily. Certainly the only good meal of their day.

Kermit loves to feed people. He feeds a group of 85 HIV + people with their families. He figures that must feed at least 850 people a month when you take in all the relatives. This is rice, meat, and vegetables. I remember one dinner in Nairobi and Kermit going over the figures of what it would cost to feed 1,000,000 people for a year. Don’t remember the exact number but it wasn’t very much.

The medical clinic part I’ve pretty much worked myself out of a job. Florence and her staff have done an amazing job, first rate even by US standards, of providing care in the Ray of Hope Clinic. When I return there I usually go for 1 or 2 weeks of free care and medicine but I now feel they’re doing such a good job that I’m just in the way. The staff there does humor me though.

This last visit I was lucky enough to get to bring my 17-year-old daughter Katie with me. At the time it was the summer between here junior and senior high school years. I think it is so important for our young people to see the third world up close. Kate was energized by it. I made her do all the scut work- shaving heads and applying gentian violet to the heads for ringworm, applying scabicide from chin to toes for scabies. I’ll always remember her face when she got to see a delivery and take care of the newborn. I was so proud of her, she’s the only one out of all my five children wants to go into medicine and she loved it.

Nairobi is a wonderful vibrant city, perhaps the most forward in Africa as far as human rights, democratic principles and education. I enjoy visiting there, walking downtown, going to the restaurants and haggling with the street market vendors. I once got to go on a long weekend to the Masai Mara and it was spectacular. The problem is the lack of capital and jobs for the majority of people. If you are the elite, the connected or lucky enough to have a job it’s a very decent place to live. There are rougly 3,000,000 people in Nairobi. 2,000,000 live in the slums. There’s no infrastructure, water maybe delivered once or twice weekly to a community spigot, and little investment in those places to make them decent to live in. While unskilled workers work for anything, there are also professionals like doctors who make less than 300 us dollars a month.

I remember when I lived in Idaho and all the tillable land in the county would be ready to seed in 48 hours when the time was right. Big tractors, big fields. In Kenya there are small tractors but mostly 60 workers with hoes doing the tilling. Street repairs are 20 guys with picks working away. Contrast here where capital is cheap and labor is expensive to Kenya where capital is expensive and workers go begging.

On my last couple recent visits things have gotten better. A new constitution was approved. In my experience (which counts for little), people are healthier. Programs like PETA have provided free HIV testing and more importantly free HIV drugs to treat this disease that has devastated Africa. Before there was no reason to test for HIV, simply because even though there was treatment none but the most wealthy could possibly obtain it. Being an African doctor too often is an exercise in futility the doctor for the poor knows he has this and that treatment for a certain problem but its pretty much an intellectual discussion because the patient has a tough time just getting the funds to eat. At least here in America we have the opportunity to go into bankruptcy if we can’t afford an expensive treatment.

Kermit’s life from the beginning was an uphill struggle. I would write about rehabilitation and repentance but I think the Kermit NBA incident was just another tough obstacle in a life full of tough obstacles. After reading a lot and thinking about the writings of so called sports experts (doesn’t take you too far up the evolutionary ladder, does it?) I think a lot of the continual judgment and criticism after all these years is covert, subtle racism. One sees a lot of this these days with President Obama, another truly American kid whose success was based on merit rather than privilege. We’ve got a lot of angry white people in this country.

I can’t begin to understand why Kermit does what he does. It exhausts me. Why would someone like him work like a dog to support a few poor forsaken people with no resources in a far corner of the world?

The answer is easy. If we’re normal good unselfish people we by nature take care of people who are less fortunate than we are. That’s what makes us human. Kermit just goes a quantum leap farther. Kermit is a great person and human being. A topic of discussion in sports is should we make heroes out of our athletes just for their athletic greatness. When it comes to Kermit Washington the athletic greatness is just the window dressing, the rest of the man is beautiful.

He possesses all the traits that it takes to be a Great American. A work ethic second to none, unselfishness, putting others ahead of yourself and perseverance in the face of great obstacles.

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