Kenya: Gone on Safari

Work's finished and it's time for safari!  Please take in the last official post of our trip.

The last few days were spent finishing up at the hospital and the clinic in the village.  Rounds, treating malaria in the clinic, and watching the clinic's new reception being built were the main events of note.  We even had dinner last night at Brenda's, prepared by her two sisters and mother - boy was it amazing.  Daniela, Brenda's 2 year-old daughter, even has her English up to speed.  We'd ask her "How are you?"  She responds, "I'm fine."  (Those are the most commonly known phrases by the kids here.)  We've definitely explored Kenyan and Indian food to the fullest, and I actually look forward to some Indian food when I return home.  Never thought I'd say that.

It is difficult to capture all the appreciation we have for your support and prayers throughout this trip.  Through your donations we purchased and gave out all our children's multivitamins, handed out toothpaste and toothbrushes to those who needed them, re-stocked about 18 different medications (antibiotics, phenergan suspension for nausea/vomiting, children's tylenol, etc.), handed out glasses and gave reading glasses to the Tenwek hospital crew, left a number of medications from home for emergency use only, gave coloring books, crayons, workbooks, pens and lollipops to roughly 150 kids, and even purchased cooking supplies for one of Brendas' mothers.  Their smiles showed their appreciation, but from us we say "thank you" for your open hearts.  We truly cannot thank you enough - what an honor and a blessing.

This has been an invaluable learning opportunity for me, as a repeat trip to a developing country, challenging my patience and shaping my attitudes.  There are so many projects here, intended to serve the population in poverty, where the ball is actually being dropped:  there is still a huge need for reliable transportation (well-maintained vehicles and smooth roads), the effective distribution of bed nets to those who truly need them, closer access to clean drinking water, and an increased emphasis on the prevention of the spread of HIV.  For the failures, there are plenty of successes as well:  motorbikes now fill the roads getting citizens to and from their destinations quicker, internet access has exploded keeping people better informed on current events and public health measures, anti-retroviral medications are available to those mothers who deliver in the hospital to try to prevent vertical transmission of HIV, and more community health workers are devoting their work-week to improving the health of Kenyans.  There are plenty to build on.  One of the most valuable lessons revolves around respecting what you don't know.  We don't know everything.  Especially when we don't live in the community we're serving.  And a clear and open mind with respect to this can bring one closer to success.

There is a plethora of projects going on here, and the main need for improvement is in the coordination between them.  Filling in the small holes.  Connecting the dots.  Adding the last few small pieces to the puzzle.  And I hope to help with that. 


The true soldiers and "saints," really, in all this, are Josh, Brenda, and Aduda.  Josh, the Bonyo's Kenya Mission #1 here in Kisumu, who ensures the clinic operates smoothly for those in and around Masara.  Brenda, the social / community health worker who gives her time to educating pregnant mothers and young schoolgirls on STI's among other public health measures.  (And let's not forget her father, "Papa Joshua," the clinical officer who offers his experience and charisma to her endeavors.)  Aduda, the former salesman, who believes so strongly in preventing HIV spread and educating those living with TB and AIDS, that he travels by public transport to the villages for surprise home visits to ensure compliance.  I have learned from their actions, and can only hope to support their work further in the future.

In the end, I've learned that the health of all peoples boils down to education.  If you don't understand that germs are on your hands, even if they don't look soiled, you will not prevent the spread of many diseases, especially diarrheal illness.  If you don't understand proper baby-feeding techniques, then you'll continue to feed fresh cow's milk directly to your newborn which can be harsh on their young gut (yes, this happens).  If you don't understand that forcing baby teeth to fall out with nails (yes, as in "hammer-and-nails" - this happens too), then infections will continue to hurt young children.  Expanding the public health educational efforts, and simply expanding the number of children able to complete secondary school, will drastically improve health in this area. 

Finally, what I take from this particular trip is the desire to use all the many little luxuries I've been blessed with, that built the foundation of my knowledge, to strive with extra effort to reach my full potential.  Most children here can't even focus enough in school due only to hunger.  How can I not take advantage of all I have, to do my absolute best?!  It would be a disgrace. 

In the end, my buddy Dan, the manager of the Milimani Resort Hotel, our home for the last three weeks who says, "We live like lions."  They wander throughout the day, with no intentional direction.  But, when an antelope comes along, they eat.

There is no need for plans.  When the antelope comes, you'll be there.

The finale from Mom:

Hi all!  This will probably be our last post as we leave for the Masai Mara and safari early in the morning.  We said goodbye to all our friends at the clinic after seeing several more patients (all with malaria).  I presented our blessed shell to the social worker, Brenda, and we both got a little teary.  She has been such a wonder for this village bringing lots of programs which I think will have a great impact.  It has been a profound and moving experience to be here and I'm sure this will be with me the rest of my life.  There is such great need here (in my eyes) and I hope to be sharing some of our ideas for continued support of this village.  Each day in the village for most people is about surviving and basic needs.  We've been so warmly welcomed and Josh, our host, has taken good care of us.  I feel blessed to have made this journey and especially to have this bonding time with Travis.  He's a very good traveling partner as you won't be surprised to hear.  He's good at keeping his cool when I'm losing mine and getting frustrated.

Last night we had the honor having dinner with Brenda and her family which included her mom, dad, 2 sisters and 2 yr old daughter.  We had such wonderful Kenya dishes such as beef stew with rice, kale and spinach, roasted potatoes, tomato/red onion/cabbage salad, fried chicken abd chipati bread.  Quite fabulous!  And as if this wasn't enough, Brenda's mom presented me with some gorgeous Aftican fabric of yellow and purple.  I'd worn my new African-made dress with zebras which Brenda had helped me have made so her mom knew how much I love the fabrics here. That was an incredibly generous gift and I was quite moved.

Today, we've been taking care of last minute business and we took Josh to lunch.  He's been such a great resource this whole trip.  Tonight, we're having dinner at Dan (hotel onsite manager) and Stella's and we're very excited about that.  Got lots of packing to do and decisions about what I'll leave behind since I need lots of room for gifts, etc.  Ha! I'm thrilled about the safari and can't wait to see all the many animals there.  I miss you all so much and look forward to seeing you soon. Many thanks again for all of your love and support!

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Asante sana for all  your prayers and support.  We can't wait to share in person when we return.

Kenya + George W. Bush

Yes, that's right my R friends, I finally found someone here in Kisumu who likes George W. Bush!  It was a dark and stormy night...well, just dark, and we slammed a wonderful pizza dinner.  Mom and I actually started with a beautiful sunset view from atop the Imperial Hotel.  We could see mountains to the north and Lake Victoria to the west.  Our small set of appetizers included beef and chicken sandwiches with chips masala - our new favorite dish.  Chips masala are basically french fries smothered in spices similar to curry.  Taken with tomato sauce (Ketchup), they're amazing after a long day.

For dinner we headed to the Grill House.  A hawaiian pizza, more chips masala, and another cold Tusker later, Brenda showed up and got her dinner.  Mom was tired from another long day, and it was a big Saturday night here in Kisumu, so Brenda took me out after dropping Mom at our hotel...

The night started at a bar called Quorum - a simple two-storied place, with blaring Congolese and Bongo music, full-blast ceiling fans, and about 90% men.  I had some Hunter's Choice (Kenyan scotch) and a Coca-cola, while she continued to down Smirnoff Ice Black - her go-to drink apparently.  Each time I wanted to say something to the waiter, she would teach me the term/request in Kiswahili, I'd say it, and he'd smile big.  

Quorum's scene wasn't enough, so we tuk-tuk'ed it (jet-ski / tricycle / golf-cart mash-up) over to Tumeez.  Yes, Annette, TUMEEZ!  We paid an extra $2.50 or so to get upstairs and boy was it worth it.  There were more Congolese, Bongo, and Kenyan jams, mixed with an occasional Rihanna #1 from 2008.  They even played the one Bongo song I knew - "Cinderella" by Ali Kiba - requested in Dustin's honor!  I ordered a Bond 7 (Whiskey) with Coca-cola, and they served me my own probably 16-oz. bottle of Bond 7 with a glass bottle of Coca-cola - the typical method.  We enjoyed the music, danced a little to ourselves, and then...

...Then, we met Aduda.  Within about 5 minutes he dropped the terms "PEPFAR" and "George W. Bush" and I knew we were going to get along.  He works doing monitoring of a PEPFAR-funded project (President's Emergency Plan for AIDS Relief) - he goes out to houses, "surprises" the inhabitants and makes sure they are taking their "ARV's" (HAART, or Anti-Retroviral Therapy) for their HIV/AIDS and/or their anti-TB meds.  So, he never exactly said he "liked" W., but he was definitely proud of the work he's doing, and proud of the fact that it was funded by PEPFAR, started by Bush.  I probably shouted "Texas" about 5 - 10 times within the next 10 minutes, but I'm not sure anyone else noticed on account of the loud music.  I'm hoping to ride out with Aduda at some point in the next few days to observe his work-day.  It is absolutely amazing the work being done around here - there is more collaboration that needs to be done though.  If Brenda didn't know him, she did now, and it was good they met.

"Moto" was Aduda's buddy.  He was dubbed "Moto," by me of course because it means "Fire," because he seemed to be impressing all the women around him.  "Moto's" game was alcohol-enhanced.  His eyes appeared heavy by about midnight, and then 30 minutes later a near brawl started by Moto almost got him kicked out of Tumeez.  Brenda and I avoided the crossfire and left soon thereafter.

Currently reading The White Man's Burden by William Easterly and it is blowing my mind.  It is quite the polar opposite of Jeffrey Sach's End of Poverty, which I read after my first trip to Kenya/Tanzania.  Easterly talks a lot about the "Planners" and bureaucrats who are trying to do the glamorous of ending extreme poverty for the 1 billion (of Earth's 6 billion people) who live on less than $1 per day, versus the "Searchers" who are finding small projects, accomplishing them, and listening to feedback from those they serve, constantly (and accurately) evaluating their successes and failures.  No matter the side of the political aisle you're on, each president starting with Clinton has stuck his neck out for the developing world.  Clinton once negotiated the price of Anti-retrovirals down to about 1/5th their previous cost to developing countries.  Bush doubled the amount of aid given by the U.S., and even began attempts to give primarily to responsible (or not-as-corrupt) governments though the Millennium Challenge Corporation .  But Easterly has brought attention to the imperfections of Bush's "big push" - PEPFAR actually spends on expensive ARV's and doesn't focus enough on prevention of spread (which is MUCH cheaper - condoms cost less!).  That's already more than you asked for, but reading this book, mixed with conversations with Brenda, rounding on sick hospital patients, long days, hot sun, and Bond 7, made my chat with Aduda one of the most stimulating conversations I've had in my entire life.

The Bond 7, Hunter's Choice, and late night did not stop us from attending church the next morning.  We were picked up at 6 a.m. and arrived at 07:18 for a 7-a.m. service that ended up getting started around 07:37.  We made it in plenty of time!  The 2-hour service started with procession from outside, starting with the kids, followed by the choir of older women.  The music was unreal.  The keyboard in the background helped, but it was essentially a-capella - the sound forces tears out of your eyes.  It was an emotional experience for the both of us, but taking in all the sights, smells, and now sounds for Mom really moved her.  Tom, Dr. Bonyo's step-brother and also teacher in the church, invited us up to introduce ourselves.  Two other guys introduced themselves and had the crowd roaring laughing - it was a tough act to follow!  We said our sincere thanks, Ero komano.  

We returned home to a long nap up until dinner.  Dinner was an American-style pizza (found!) with some spinach and a salad.  Finally, a salad for Mom!  

This morning, we were back at it at the clinic.  We saw about 14 today - the word was out since church on Sunday.  We treated probably half of those for malaria, confirmed by the Rapid Diagnostic Tests we found in our own pharmacy.  Malaria is typically treated clinically (based on symptoms) out in rural areas, but the more scientific method is to use a peripheral blood smear.  If that's not available, these rapid tests are available.  No test is perfect, but after a negative control on one of our hosts, the rest have been positive.  There were a few others - some with backache, PID, arthritis, diarrhea and the like.  You would have backache too if you were 60 years-old, stooped over at a 90-degree angle in 90-degree heat, harvesting in the rice fields all day!  They don't seem to take time to drink water either, so I push them to drink plenty of water and take Ibuprofen only as needed.

Mom proved to be a worthy assistant today, but I fear my frustrations with our "clinic flow," or lack thereof, might have made me appear less than appreciative.  I think I fixed the clinic flow for the better, and my attitude toward Mom was nothing a fat plate of chips masala can't fix.

Also at the clinic today was a crew from Tenwek - a German-funded Eye Hospital - to pick up 40 patients identified last month as clients who could benefit from their ophthalmologic services.  Only about 15 showed up.  Tenwek has surgeons who fix mainly cataracts and trachoma.  The cataracts they fix for the equivalent of $36, and some they do cheaper I think.  The crew also helped with optometry and refractive services while at our clinic today.  Mom even gave them a bag-full of reading glasses that we'd brought and they were very appreciative.  They loaded their patients up on a bus and headed out - to return with them on Wednesday after helping ALL of our patients they took.

Again, it's amazing all of the many services that are down here - but there's more to be done.

So, who knows what tomorrow will bring - the plan is constantly changing.  We are getting used to "Kenyan time," with Josh (our unbelievable host) being the only one truly on time - he and we now call it "Josh time" just so we are clear when to actually pay close attention to our watches.

More from Mom: 

My editor tells me to shorten my posts. Yesterday (Sun.) was an emotional day. We started off at 6:30 a.m. for church service in Masara at a Catholic church.  The service was quite moving. It began with the choir processing in singing so beautifully I was almost in tears.  How can these people who live in such poverty be joyful and so spirit-filled?  Women and men are segregated with women and children in front and men (and visitors) in back. The church is a school during the week and is open-air but quite cool that early in the morning. Near the end of the 2 hr service, Trav and I, as well as 2 visitors, were asked to come to the front and speak. We were welcomed and we got to express our gratitude for being able to worship with them. Their faces were smiling and radiant.  We are all one in the spirit yet such radically different living conditions.

The excitement and shock have worn off and I was a bit teary yday realizing that THIS IS REAL!  What can I do to help?  Trav wisely counseled that we control what we can and do little things that can make a difference to one person at a time.  Afternoon spent napping at hotel and sitting out by the pool reading. While at the pool, a beautiful woman and her son (Obama, age 1) and dtr, (Tana, age 3) sat by me. The girl reached for my hand and smiled and examined my hand.  Very sweet.  Dinner was at the 711 Italian Restaurant and Pizzeria. I got the most delicious mixed greens salad with lots of veggies, sauteed spinach and T had a chicken pizza.

Today we went out to the clinic where word had gotten out that we were coming. We saw 14 patients, mostly kids needing malaria treatment.  I spent much of my time running to the "pharmacy" for medications.  There was a group there from an eye clinic (3 hrs away) picking up about 12 people for eye surgery (cataracts, retinal, prosthetic eye).  Many of the eyeglasses I collected were sent with them as their need was quite great.  I included an eyeglass repair kit and was told this was "an answer to prayer". Something so simple yet so needed.

We came back to town and Brenda, the Social Worker and I were dropped off at her tailors.  I was measured for a couple of skirts and a blouse.  They will be ready by Sat. and the total cost is about $27. Amazing!  We're now at a shopping area and will do a little gift-buying as well as get more goodies for the kids.  Trav made a run by the pharmacy here to get much needed meds for the clinic. We'll chill at the hotel for dinner and relax. Tomorrow, we'll return to the hospital for more learning and rounds.  There was some talk with our driver, Josh, about going to the equator and Lake Victoria on Sunday. Can you believe this?  WOW. That's all for today.  Love to you all and take a moment today to count your many blessings.  We have such abundance in the states!

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Asante sana for your support and prayers.  Much love.