Saturday, December 4, 2010

Learning lessons and saying good-bye

The last few weeks have been rich, full of activity and pretty funny events to store in our memories.  The renovations at Oloile Secondary School started as the school year was coming to a close and are now in full effect.  Mike has been busy working with the local building teams and the school is looking absolutely beautiful! The students are thrilled and eager to return to new classrooms (fully equipped with windows, doors, and solid floors) in January.  It has been really great to watch the guys all working together and learning from each other.  Mike has learned some of the ins and outs of building in a small town in Kenya and he has taught the team new ways of performing quality work.
Mike with the local building team

Our hope is that this school continues to develop into a safe haven for learning, one that encourages the students to strive for excellence.  We have observed the tendency among many of the local students to settle for less than average in their schoolwork.  The Kenyan school system is based upon exams, two to be exact.  One's entire grade for the year is based upon two exam scores (I totally would have failed in school!). We have been told that teachers will teach to the exams and will rarely have the time or desire to venture outside the syllabus.  The students only require a D+ to pass!  That means they have an understanding of no more than 40% of the information.  I find this unsatisfactory, especially if students are striving to compete in our global job market.  Two major obstacles are the past and the future.  The students come to Oloile from various backgrounds with different levels of education.  You can imagine it would be difficult to teach in such a linear fashion directed towards passing an exam if you have students with such a vast difference in their educational background.  Once they have completed secondary school, many have no way to continue their education.  Approximately 80% of the students of Oloile receive sponsorship to attend. However, there is no funding for students to move on to university, a challenge that requires some consideration and additional fundraising.  So many of the students wish to pursue additional education, earn a professional degree and do things to improve their country.  Unfortunately, many will finish secondary school and have no opportunity to continue with their education.  But, they have such big dreams!

Outside before
 During the last 2 weeks of school, I presented an opportunity to the students to earn some school supplies for the coming school year (thanks to Sarah, Jim, Maddy, and Sam for donating all the school supplies!).  Those interested were to submit a short essay regarding their dreams and how they planned to make their dreams come true.  It was quite inspiring to read the students' reflections about ambitions to become doctors, lawyers, engineers, news broadcasters, and many more.  They wrote about how they have to work hard, remain disciplined and not give into many of the temptations surrounding them in order to make their dreams a reality.  Our hope is that Oloile becomes an exceptional school in that demands more and creates opportunities for success among its students so that they can fulfill their dreams.  One also that can become self sustaining for the community.   One that can prove that change is possible.
Inside before

Outside After (still in process)

Inside after
Walking bridge to school
Change is difficult in any environment.  One thing is certain though, change must come from within.  You cannot enter a community with a "fix-it" or savior mentality, which is all too often the mindset of our western world.  You must enter humbly with the hope that you will be welcomed by a community to sit and to listen, to share stories, and to learn how and why things are done.  It is easy to judge from a detached point of view, but start having conversations and it becomes a lot more complex with the

inter-workings of local culture, history, economic development, family structures, and resource availability.  Kenya is ripe for new growth and development, but it is a challenge that demands individual desire and participation from within.  There is a fine line between aid that empowers and disempowers a community.  Even with the best of intentions, foreign aid can sometimes disable the self sustaining efforts of a community.  We wrestle with the tension between entitlement and empowerment, for instance, as we walk down the street and every child screams at you  "mzunguli" (roughly "my white person") and "give me sweet/money/pen/pencil!"  There are several exceptional individuals with whom we have had the privilege to know here who are working very hard to create positive change from within their communities.  As much as I believe foreign aid must continue, it must do so in ways that create partnerships and works from within to empower communities to create their own desired changes. I find that it is a time in which individuals can and must be encouraged to stretch beyond mediocrity to that of expectations for more.  It is also a time stretch a bit beyond personal survival and fulfillment to embrace the need to make changes for the greater good (a challenge we also struggle with greatly in America, uhemm... anyone want to discuss healthcare?)   It is a challenge we face across the globe. Having spent only a little over 3 months here, I admit that I am in no way an expert on Kenyan affairs.  But, we have learned many lessons from our teachers in Kenya and we will continue to wrestle with these issues.  We hope our time here has been a step in the direction of empowerment.  We have learned so much from those around us and we can only hope we have planted some seeds here as well.

And so, it was with a mix of sadness and anticipation that we left Kimana on Thursday, Dec. 2.  Sadness, as we are going to miss everyone so much and we would like to stay to continue working.  And, anticipation as we look forward to seeing our families at home, and, hopefully, returning to Kenya again in the future.
Saying good-bye in Kimana
Mama Nasieku made us all our favorite meals during the days before departing including githeri and chapatis! I was able to spend all day on Wednesday working in Mama Nasieku's shamba (farmland) harvesting green peppers.  It is ridiculous to witness the strength of African women. Try carrying 150 pound bags of peppers on your back!  It is so hard and they make it look so easy!

We had a lovely morning on Thursday, sipping chai and sharing pictures.  Then, we had a tearful goodbye and we drove off....and, about 200 yards later, we got completely stuck in the mud!  It was awesome.  Nearly 4 months in Kenya without getting stuck in the mud and we get stuck on the last day!  Of course.  It was quite a comical site. Mike advised me to drive as all the men pushed the car out of a deep hole.  We successfully got the car out and I drove to more solid ground.  I took a deep breath, looked down and laughed hysterically.  In all the excitement (I was totally afraid I was going to drive deeper into the hole, or that the car was going to fall over), I had forgotten to take off the emergency brake!  Well, mike needed a good work-out anyway:)  Hakuna Matata.

No explanation needed!
We made it to Nairobi where we have been enjoying time with friends.  Our wonderful and wise friend, Mr. Juma, had us to his home in Kiserian for lunch with the family en route to Nairobi.  It was a lovely time and we were so grateful to spend time with his family before departing.  We are currently in Nairobi staying with Delphin and Fabiola, our gracious family in Nairobi:)  We ventured to Lake Nakuru and Lake Naivasha yesterday where we saw flamingos, buffalo, zebras, gazelles, impalas, baboons, and, oh yes, hippos mating (quite a site!).  We also had a little adventure with some baboons climbing into our car to steal some juice and a banana peal...they climbed in through the open roof!  
We plan to relax and say a few more good-byes over the next few days.  It is very surreal right now, as it always is after such a short period of rapid transitions. We are beyond grateful for this opportunity, for the lessons we have learned and the many that will continue to surface.  Peace to you all and thanks for all your support.
Standing above Lake Nakuru

Thursday, November 25, 2010

Happy Thanksgiving!

Happy Thanksgiving!  It is hard to believe it is Thanksgiving as it is about 100 degrees here with blue skies as far as the eye can see.  We hope you are all enjoying a wonderful Thanksgiving celebration wherever you may be in the world!  We plan to celebrate with our Kenyan family with a dessert of watermelon and sodas.  I am not brave enough to prepare a Thanksgiving meal on an outdoor fire…nor am I brave enough to kill a bird and pluck it!  So, we will have metoke, which is a wonderful stew of bananas and potatoes.  We find it very important on this Thanksgiving holiday to give thanks to all our friends and family!  We love and miss you, and we are so grateful to all of you for supporting us along this journey.   We are looking forward to sharing more of our adventures when we return in a few weeks.  We cannot thank you enough for helping to make this experience happen.  I will write more and send pictures soon (very limited battery right now and nowhere to chargeJ).  Love and blessings to you all!

Friday, November 19, 2010

A few more weeks

It has been a while since I have written.  It has been a mix of emotions as we keep busy with new projects and dive deeper into relationships here, and as we prepare to leave in just a few short weeks. It is so difficult to believe we are leaving so soon.  We continue to remain present to our lives here, and we look forward to building upon these experiences in the future.  We have started to be able to listen and understand conversations...and respond slowly, which is usually mixed with a bit of laughter from everyone.  It is good.

The last several weeks since leaving Karero have been busy.  We spent a couple days in Nairobi where we had to renew our visas. I consulted with some of the local physicians regarding an interesting case at Nairobi hospital - thank you to all you wonderful physicians who consulted from America.  It was pretty incredible to be seeing a patient in a hospital in Kenya, and then receiving consults from specialists in America only hours later.  The boy is making progress and we hope for more answers as he recovers.

Since returning to Kimana, we have been busy teaching and doing renovations at Oloile.  Mike has been leading local teams through complete renovation of multiple classrooms. It is already looking so much better.  The concrete in all of the classrooms was completely chipped with deep holes and cracks.  Some rooms still have no floor aside from gravel.  We spent the first few days getting dirty as we demolished the existing floors...oh, nothing like destroying concrete with a sledgehammer and then shoveling.  SO MUCH DUST!!!  There is a bit more demolishing to accomplish, but they have already started to pour new floors and they plan to lay tile on Monday!  The students are really excited for the new classrooms as well as the new girls' dormitory that will be constructed.  We hope the new classrooms will not only attract more students, but empower the current students to take better care of the school.

The health club continues to be active at the school. One of the classes put together a drama performance about cholera.  It was great to see them get excited about a subject that is so relevant to the health of their communities, and then to design a play to teach their peers.  I have also met with all the female students and they plan to continue a girls' club next year.  The school year here is January through December with month-long breaks every three months, so they are about to break for holiday next week.  I hope the excitement of their clubs will carry over to next year:)  I am doing a final HIV/AIDS teaching with the entire school on Monday, including many faculty who will participate.  I will do free HIV testing following the seminar.  The clinic has generously donated several HIV testing kits, so we will see how it goes.

Aside from work at the school, I have been participating in a mass treatment for trachoma eye infections...a very common infection here that causes blindness.  It is an 8-day long outreach where several teams go out into the communities, particularly the schools, churches, and bomas, giving antibiotics to everyone. It has been great to work with local volunteers and public health teams.

So much more to say as there has been so much to process, but that is a quick update. I hope to write more and send pictures soon.  As much as we are sad to leave here, we are looking forward to seeing all of you when we return!

Saturday, November 6, 2010

Leaving Karero...

It was a busy week in Karero full of projects and patients.  We showed up to a beautiful site!  The clinic looked wonderful.  The community has taken such good care of it, creating walking and car paths and keeping it clean.  The rains came so we stayed a few more days than expected, which was really a blessing.  Mike and I put in windows using clear plastic instead of glass.  Mike brilliantly figured out a way to make the windows open and close to accommodate for the fluctuations in the weather.  Oh my wise husband!  The Maasai have given him a new Maasai name, Eloshordro (El – oh – shor –dro, you have to roll the “r”s with your tongue).  It means something like “the one who gives of his heart without asking.”  Typical Mike fashion, he works diligently and quietly and, before you know it, things are done!  He is an inspirational fellow that one.  The windows work really well to protect against the heat, wind, dust, and various animal noises.  We also tiled the bathing room floor as the concrete was quickly eroding from all the water.  And, we built a door for one of the rooms.  It was quite a site watching two westerners construct a door with old, run-down wood and some rusty nails.  We had some help from the locals and it turned out really well. 

It was a busy week with some complicated patients.  We went to the nearby boma to visit a woman who had had stillbirth at 8 months.  This was her second miscarriage. She was very dizzy, lightheaded, and weak.   Lab tests are limited in Karero without electricity and we have no way of getting hematocrit or hemoglobin, but I expected both tests would have been extremely low. She was so anemic that her tongue was white. We walked to her boma, brought her to the clinic where we were able to do an exam, give her some IV fluid, medication (vitamins, antibiotics, and analgesics) and to observe her for several hours while she rested.  It started pouring while she was at the clinic so she was stuck with us for several hours! She stabilized with foods, fluids, and rest.  I instructed to get to the clinic in Namanga for lab tests.  I checked on her the next day in her home where we shared tea.   It turns out she is the wife of the man whose head I sewed up the first night we arrived!  She was doing a bit better. As expected, she did not tolerate the vitamins I gave her... imagine prenatals on an empty stomach, yuck!  She was told to keep trying and to take with food.  I expect a slow steady recovery.  Her husband and all the other women in her boma were extremely supportive. I was told that after a woman gives birth or miscarries, she often resides in her manyatta (the house within the boma) for a whole month while the other women take care of her and the other children.  It is a beautiful lesson in community. Her husband was very grateful, and offered to slaughter a goat for us next week!  I told him it was unnecessary, but that he had to take care of his wife.  He agreed:) 

We had a very complicated patient the last night we were there.  A mama brought her two-year-old baby in at about 9pm complaining she had been having “convulsions” through the day.  She said she had about four convulsions without any other symptoms.  She had similar symptoms about 1 month ago when she was diagnosed and treated for malaria.  I assessed her and she was burning up with a fever of 39.1C, otherwise unremarkable.  She had a normal affect for a sick child, alert and responsive without any seizure activity.  Her blood slide was negative for malaria.  I diagnosed her with febrile seizures and covered her for infection with both septra and AL for malaria.  Her fever was reduced with paracetamol.  She was given clean water and instructed to push fluids and return in the morning for reassessment.  When she returned, she was afebrile, but very lethargic. Mama said she had had a few convulsions in the morning.  I was concerned that this was much more than just febrile seizures. Her typhoid test was negative.  There was no history of trauma and no family history, so far as we could tell, of seizure activity (but this is hard to determine!).  She had a small seizure in the clinic that lasted for about 1 minute, despite the anti-seizure medication that was given.  It was helpful, although very difficult, to observe the type and duration of seizure.  The child was postictal.  Our concern, obviously, was that this child would continue to seize and suffer irreparable damage.  She needed to get to the district hospital asap where they could observe her and perform more tests.  Tyson was expected to come to Karero to pick us up and he arrived just as I was calling him to tell him we needed to take this baby to the hospital.  I was really worried he would not make it due to the rains and the roads, but thankfully he arrived just in time.  Again, it was really incredible to watch the community come together.   The baby’s father was not around, but several men in the community came to discuss how they could get this mama and baby to the hospital.  Most people will not go to the hospital when referred because they cannot afford transportation.  The district hospital is in Kajiedo which is about 2 ½ hours from Karero.  They have to get a motorbike or car to come to Karero and drive them to the main road in Mal tisa, which is about 400 Ksh.  Then, they have to get a matatu (the local bus system which is terrifying – imagine 20 people in a small minivan with people hanging out the doors and on the roof travelling along bumpy roads!).  The matatu to Kajiedo costs about 200 ksh.  We all worked together to find a solution.   The plan was to drive them to the main road where they would then get a ride to the hospital.  Ester, the mama, baby, one of the men from the community, and another older mama came with us to Mal tisa.  I was a bit concerned about them making to to the hospital, so we ended up just driving all the way to the district hospital where the child was admitted immediately.  I was so thankful for the Kenyan doctor that we met right away.  We discussed the situation and we were immediately on the same page.  She was started on IV diazepam (valium), given IV fluids with dextrose, treated with quinine for malaria and was going to have more blood work and an EEG, if possible.  The hospital took the baby with the mama and they will take care of her, keeping her at least through Monday.  The baby had several small seizures en route to the hospital and was post ictal and sleeping the rest of the time in my arms.  The mama was having a very hard time observing all of this, as expected, as it is incredibly difficult to help a little one through a seizure.  Thankfully, the seizures were short and her airway was not compromised.  We all worked together to care for her and she made it safely.  My hope is that the seizures are secondary to a curable illness or electrolyte imbalance, but I am also concerned about epilepsy…especially if there has been a history of seizures in the past (again, hard to determine).   It will be very difficult if the result is in fact a chronic illness that requires frequent observation and continuous medication.   I hope and pray for the recovery of this baby.  It was a true experience of the challenges facing much of the rural population in Kenya.  It was also a tribute to how important it is to have a clinic in Karero where there are hardly any other resources.  I am not sure what the outcome would have been for this little one had they had no place to go, or had they walked four hours through the bush to the other nearest clinic.  Thank you to all of you who have helped create and sustain the clinic…you helped save a baby’s life.

We will not be returning to Karero during the remainder of our time here.  We will really miss living and working with the community.  I must mention that the use of alcohol in Karero has drastically reduced, if not disappeared.  Those women really made a difference when they protested last month!  All the stores have stopped selling alcohol.  We got to spend a lot of quality time with the ladies at the clinic as well as several members of the community.  We hope we can return there again to continue to work with the community….perhaps next year to build some housing for the ladies at the clinic???  Although, the Maasai women have informed me that I should have at least two babies by now so maybe that will have to come first!  We cannot express our gratitude towards Ester, Faith, and Joyce, as well as towards the entire community for welcoming and taking care of us while we were in Karero.  We cannot begin to articulate all that we have and continue to learn.  This last trip to Karero allowed us to go deeper into the community, and I believe it is a testament to time…time spent sharing, sitting, drinking chai, and lots of time spent laughing as we were trying to communicate in different languages.   It has been the exchange of stories that, I believe, will generate the most change. Perhaps we have all gained a little more global perspective, become a little more patient with that which we initially don’t understand, and gained a little more stillness with that which feels so uncomfortable.  This is my hope.

Now, back to Kimana!  We have only about 1 month left of our journey.   I have almost completely lost track of time, so it seems bazaar to make note of that timeframe. The money has arrived for more renovations and the building of the girls’ dormitory at Oloile!  We are going to be busy organizing, building, and teaching.  Thank you again to all of you for making this journey possible.  Peace to you all!

Sunday, October 31, 2010


Back at Tizi camp, this is likely our last trip to Mal Tisa and Karero.  This has been our little home away from home.  We spent the night discussing various strengths and challenges in Kenya.  That is to say, we have been wrestling with and talking about our experience of what we understand to be strengths and challenges.  I say this with great humility as a mzungu who has only been in Kenya for 2 months.  I remember struggling with something similar in JVC…struggling with owning and reflecting upon my understanding of my lived experience. I was working in an AIDS hospice, which was very difficult at times.  For months upon end I refused to acknowledge my own sadness and grief because I did not think I was “worthy” for such feelings. After all, who was I to be sad or to grieve when the real suffering was occurring in the lives around me.  Well, time (and many months of therapy) revealed to me the absurdity of this egotistical way of thinking and I finally embraced my own experience of the life I was living.  As I finally came to realize, who was I not to be sad or to grieve?

That being explained (again to myself) I now embrace my understanding of my lived experience in Kenya.  It is hard.  Life is hard here.   There is development happening all around, but a bit of chaos throughout as various organizations work at different paces with many projects left unfinished. Most days are spent waiting, mixed with moments of hard work.  There are so many uncontrollable factors and the idea of a plan is laughable.  Poor roads, lack of supplies, unpredictable weather conditions, and, unfortunately, unreliability influence every project.  One thing holds true, the women work so hard.  They cook, clean, farm, chop wood, sew, make jewelry, and raise the children.  I struggle with the treatment of women, particularly in rural Kenya (as we have not spent much time in Nairobi so am unable to speak to urban gender roles). I can get behind clear role separation, but it is difficult to accept the lack of conversation about the role definitions.  Many of the women have no voice.  They have no options if the man drinks away the money or sleeps with other women.  There is no recourse.  I struggle with the tension between that which I can accept as “cultural” and that, which, in my opinion, is simply wrong.  I see hope in the younger generations and I believe the key is education.  I have started to teach health classes at Oloile Secondary School.   I am teaching these young adults about health, reproduction, contraception and disease.  We have started a health club, with the hope of empowering young men and women to become health consultants within their own families and communities.  My next step is to work with the young women to create a women’s group.  I would love to share discussion around individual and communal esteem so that women feel confident and entitled to stand up for their rights. I know there are exceptions to the rule, but I have seen only few of these exceptions.  Young females are at a disadvantage in society due to their gender as well as their age.  The youth grow up in a hierarchical system in which corporal punishment is liberally utilized…and without explanation. I often wonder if these kids and young adults know and understand why they are being beaten.  Do they really learn a lesson?  Do they learn not to be late because it is irresponsible and a reflection of character, or do they learn to be punctual so they are not beaten?  I think the latter.

And so are some of the challenges.  In the midst of the challenges, we are repeatedly overwhelmed with the hospitality and generosity of the people.  As I have mentioned many times before, there is bold spirit among the people.  Their resiliency and perseverance in the face of corruption and poverty continues to humble me.  It is beyond words. I always hate to generalize.  For every generalization, there are many contradictions.  But, I embrace my understanding at this time with an open invitation to learn and to grow in my insights. 

We are off to Karero now, going to check on the clinic and do a bit of work.  We are looking forward to visiting with the community and, of course, falling asleep to the sounds of hyenas.  My fear of hyenas has diminished a bit now that I have had my first black mamba sighting!  It occurred last week in Kimana and I am trying very hard to forget that snakes exist in Africa.  I think the Poisonwood Bible scarred me for life!  Anyway, we are off to the bush.  Hope to write again soon.

Monday, October 25, 2010

More pictures

Karero clinic before

Karero clinic consultation room before
Karero clinic after some cleaning, scraping, and painting

Consultation room after
Ahh, Mombasa

Dinner in Mombasa

Tyson's beautiful family - Tyson, Mama Nasieku,
(girls from left to right) Rachel, Siente, Nasieku

Saturday, October 23, 2010

The rains have come

     Another silencing rain, the first in Kimana since we have been here. It smells of freshness. If renewal had a scent, this would be it.  Mombasa was breathtaking. The Indian ocean is clear turquoise and salty.  We sat for hours reading and talking, sipping drinks and enjoying fresh fruit by the water.  It was certainly a different experience of Kenya, one we were happy (and very privileged) to enjoy. We were both grateful, however, that the beach was not our only experience of Kenya.  We are now back to our home in Kimana, enjoying the comfort of family.
      It is like a summer vacation that is rained out and the whole family (or town) is stuck inside one room.  Everything stops as the dusty roads flood and huge drops fall continuously.  We made it to town before the rains, and now it simply pours.  We sit in the “Paradise Hotel” with about 20 other people, sitting in the dark with flies all around.  The hotel is a one-room restaurant with a balcony.  The door leading outside is open and a thin white sheet separates us from the water and the light that makes its way inside.  You can feel the warm humidity all around and just have to surrender to the stickiness that pervades every inch of your body.  Painted portraits, mirrors, posters decorate the wall.  The images range from country cottages, city streets, a white baby in a cup of lettuce (in the style of Ann Geddes, unfortunately!), and a life-size poster of a white Jesus proclaiming the way, the truth, and the life.  There is no rhyme or reason to the arrangement. In fact, I wonder if there was an effort made to make it as disorderly and freestyle as possible.   There is the smell of grease, fried meat, and dust.  Several anonymous voices fill the room with constant conversation. I can hear the Maasai.  There sentences always sound like songs, continuous without pauses.  Mothers yell instructions to the little ones and I can hear little feet dragging across the room.  It is perfect.  There is energy all around.

Sitting in this hotel, I cannot help but think about how this little room is a microcosm of our experiences in Kenya.  The surroundings are often a bit disorderly and, occasionally, a bit unattractive in appearance.  But, the insides are full of spirit.  There is life in the midst of what may appear from a distance as lifeless.  There is bold spirit and relationship as thick as the humidity that permeates our surroundings.  We often find ourselves contemplating the slow change of pace in Kenya.  The rains make me realize that business life may operate slowly, but there is never a shortage or "slowness" of spirit.  There are always conversations to be shared and, of course, hot chai to drink.  Faces often stare at us blankly, but with curiousity.  The moment you say “jambo” or “habari” the stares soften into smiles and, almost, an awakening as if he or she did not realize they were in the midst of an intense gaze, and they respond with a sweetness that appears genuine and happy to make the aquantaince of someone new.  We are humbled and grateful to be surrounded by such a welcoming majority.
The reality is that I have had to rely on all my senses to understand this community and, when it comes down to it, I will only be able to access the surface this time.  I wish I knew the language better and I finally I have a little glimpse into what it would be like to be a minority who cannot communicate. We are so lucky so many people here speak English, but it would be great to be able to converse in the native language...ah, little by little we learn.