the weight of guilt.

We had another clinical conference today-the last one before we leave! I wanted to share with you some of the thoughts that were running through my head today when thinking about homelessness and the poor. As I wrote earlier, I have spent some time in Kenya on a medical missions trip. This upcoming trip has brought back some similar feelings even though Kenya and the U.S. are so different. First of all, when I arrived in Kenya and recovered from the jet lag, I experienced culture shock. I never really knew what that was, but I know now. I was stunned by what I saw as I entered the small community where I would reside for the next three and a half weeks. Shacks...mud huts..people walking without shoes..extreme poverty. No matter how much I tried to prepare myself for the trip I was still shocked. The shock disappeared and a new "norm" appeared in it's place. The hospital where I worked had four wards with beds that reminded me of the old British hospitals from war time. The most common diagnoses were tuberculosis, malaria, AIDS/HIV, and yellow fever. I collaborated with the nursing school there and I remember one of the nursing students asking me what kind of diseases we had in the U.S. My reply? Obesity, diabetes, coronary artery disease, cancer... They didn't understand obesity, coronary artery disease or diabetes..they just looked at me in bewilderment.

The instance I will remember most from my trip was on one of our "home health" visits where we would walk from mud hut to mud hut (sometimes miles in between) and assess people to see if they were taking their antiretroviral (HIV/ADIS) medications and if they had discussed their diagnosis with their family/spouse, etc. We came upon one particular mud hut with a man lying on an old broken mattress, extremely thin and emaciated, with a smell of urine and feces. The man was dying from AIDS. His mud hut had bugs crawling all over it..he had nowhere to go to the bathroom, but in his bed. All he wanted was for us to pray with him. We did that. I will never forget this man. As he was spending his last days lying on his broken dirty mattress with bugs landing on him I was spending my days at home drinking mochas, watching t.v. at my leisure and complaining about trivial matters. The guilt weighed on me and it still does. I know we will witness and hear about people's circumstances in Washington D.C. We will most likely experience a culture shock. We will feel guilt. But what will we do about it? Continue on with our lives as usual? I hope not.

We have an obligation to promote health, equality, and justice for all. This experience should motivate all of us to be more aware of policies of our government and how to be involved in advocating for the homeless.