EXERCISE ASKARI SERPENT 2018 – KENYA

A member of 253 (NI) Medical Regiment tells of her experience on Exercise Askari Serpent in Kenya:

At the beginning of April, I travelled to North Luffenham to meet 2 Medical Regiment to begin the Reception, Staging, Onward Movement and Integration (RSOI) package prior to deploying to BATUK (British Army Training Unit) for Exercise Askari Serpent.

Exercise Askari Serpent is a 6 week exercise, in partnership with the Kenyan Defence Force Medical Services, where the British Army deliver medical care to the local population.  The overall team was 177 strong, led by 2 Medical Regiment, alongside 73 Individual augmentees from 21 different Regiments.

There were 3 Remote Area Treatment Teams (RATTs) made up of approx 30 personnel.  They each had 2 General Duties Medical Officers (GDMOs), 2-3 Nurses, a Dental team and 10-15 Combat Medical Technicians.  Each RATT was supported by Vehicle Mechanics and a Communications team.  Each RATT also had 3 embedded members of the Kenyan Defence Force (KDF) – in my RATT, the KDF consisted of a Nurse, a Physician Assistant and a Nutritionist.

The Deployment was split into 3 phases.  Healthcare was delivered in Isiolo County, Samburu County and finally Nanyuki County.  The combined focus was clinical outreach, health education (including dental) and continuing community engagement.  Each phase brought totally different experiences.  The first phase was partly urban which meant we were treating in slums and a lot of the local population were HIV positive.  It was here that I had my first experience of treating patients who had previously been treated by Witch Doctors. 

The next phase took us into extremely remote areas where we were treating Tribes.  This was fascinating work as we had to respect the traditions and beliefs of the local population whilst delivering Western medicine.  It was challenging at times as the tribes expected patients to be seen in order of their importance rather than how sick they were.  The young Warriors were forbidden to stand with the female members of the tribe so tended to stay at the back away from the queue so were unable to get to triage.  We got around this by sending experienced CMTs out to look at the queue prior to triage and if anyone looked obviously unwell, they then bypassed the queue.  We had been given cultural training prior to deployment so we knew what to expect and had learnt some basic Swahili.  The communities were extremely welcoming and grateful for the healthcare delivered and we were privileged enough to be invited to a Tribal wedding – a once in a life time experience!

The final phase had an educational focus and was in partnership with the Kenyan Red Cross.  We had extremely rewarding experiences including setting up ad hoc teaching sessions for the local children.  Simple handwashing skills are something we take for granted but is unfamiliar to them.  We had a group of about 20 children who all appeared to be under the age of 10.  We set up some basins with water, soap dispensers and blue roll. We then demonstrated what to do using the World Health Organisation 5 Moments guidelines and allowed them all to have a go.  The happiness and enjoyment on their faces was indescribable and an experience I’ll never forget!  Many of them came through the station several times just so they could keep practising.  We also got invited by the local priest to attend Mass and then teach the congregation after.  We set up 3 stands which were Dental Hygiene, Hand Washing and Basic Wound Care and we had groups of teenage school children and ladies from the congregation.  They thoroughly enjoyed it and participated fully.   

Overall the deployment was a privilege to be part of and the learning opportunities were invaluable.  I would encourage any nurse who gets the opportunity to grab it with both hands!