Sunday, February 5, 2012

Learning a lot... Kenya, part two. Sister Freda's - NOW WITH PICTURES

Originally written on 2/5/12 - pictures added on 4/12/12

(Again, no pix - sorry. I'll try to make this brief, but you all know that brevity is not my strong point - especially with no way to cheat by posting pictures. But enjoy the narrative - it's been a great week!)

Wow. The past week has really been something... where to start? Where I last left off, I guess... which was Sunday. On the way home from town, we stuffed ourselves into another matatu and then did the last leg by bicycle taxi (piki piki.) Zavion absolutely LOVED it - he sat between me and the 'driver,' putting his arms up as if he were on a roller coaster and yelling 'wheeeee!' He kept telling the driver (pedaler?) 'You're the fastest bike rider on the planet. You're very strong. This is the funnest ever!' This elicited happy chuckles from our driver. It's good to keep your bicycle pedaler happy :)

Life around the compound continues to go well and we are pretty comfortable here. Zavion can't get enough of all of the animals and especially loves the new kittens (now three weeks old) and the one week old puppies. He visits them daily. The puppies are still off limits as far as holding, but he picks up the kittens and pets them regularly. He's named a couple... let's see, there's Cutie the Kitten, Milky the white puppy and Blackie the black puppy. I've forgotten the others. There is also a 3 month old puppy that has pretty much moved in with us - sleeping on our porch and greeting us as soon as we get up each morning. Zavion spends a lot of time playing with him. His name is Luke, but Z has nicknamed him Luke McNaughtymaker, which is an appropriate moniker for such a cheeky pup. I'm pretty sure he will be the most missed when we leave tomorrow.

We have a lot of fun with the other kiddos, too (I think I mentioned them each individually in the previous post.) As soon as they see us in the morning, they come running- shouting 'Zavia! Zavia!' Sometimes, though, Z gets a little overwhelmed and we have to take a break. The kids are constantly in his face, prodding and poking, and also climbing all over his mommy for attention. They can be a little rough in their enthusiasm sometimes and Zavion, though taking it pretty well, can get understandably annoyed at times. He also gets a little frustrated at not being able to really communicate - they just don't appreciate his stories and his jokes the way he thinks they should. He's learned a few phrases of kiswahili, though, so he gives it an effort. The gentlest kids have become our favorites to hang around with - the little girls Jacqueline and Saida (yes, I said HE when I talked about Saida last time, but she is, in fact, a girl) and the boy, Morgan, who Zavi speaks of most fondly. In fact, he wanted a 'playdate' with just Morgan the other day - to show him some of his toys, give him a hand-me-down shirt, etc., but it was impossible to seperate one kiddo out from the rest as they travel in a pack. Alas, we have to take them as a whole group - all exuberant energy and unending excitement at our presence. A Z quote, "Mommy, maybe they are a little rough because they don't have mommies to teach them how to be gentle. If they had mommies, they might know how to control their roughness better."

Still, he has lots of fun with them. We bought them a soccer ball, so that is a constant source of amusement. They enjoy throwing things in the old well, chasing all of the animals, doing gymnastics, singing songs and chanting chants (the other day, Z started a chant - 'Chuba chuba chuba chuba, booo booo booo' which they now break into on a regular basis. No, I have no idea what it means.) My daily workouts consist of giving airplane spins, piggy back rides, tickle wars and upside-down carries to 12 30-50 pound kids. Usually 2 or 3 times each. There is just no way to pick up or play with one kid without then repeating it with each one. Phew. My back is paying for it :) Zavion loves giving out things to everyone - the ball, some sweeties, some pens... and he makes sure that each kid gets his/her share and isn't crowded out by the others. I wasn't planning on giving the kids any candy (you know, no dental care or anything,) but I keep using the term 'sweetie' when greeting them (as a term of endearment,) forgetting that sweetie actually means candy. They get so excited and shout, 'yes, sweetie? for me? candy?' They were unnecessarily teased so many times, that I finally broke down and got some for them.

The other day, the kids had to wrangle in a couple of run away baby cows. OK, so the cows ran away BECAUSE the kids were chasing them, but it was up to the kids to bring them back in nonetheless. Watching the effort (let by Zavion and Gail,) had me laughing so hard, I was practically crying. Kids and cows all over the place. Traipsing through fields and often around in circles. Kids shouting in various languages; cows meandering. Alas, they were eventually successful and the cows were returned, but not before putting on quite an entertaining show.

OK, back to our week. On Monday and Tuesday, I went to the district hospital in the mornings and Zavion went to class on the compound. About 120 kids, aged 3-5, travel by foot (some up to 2 hours) each week day for a feeding program/ preschool. They are fed breakfast and lunch (for some, the only meals they will eat) and given about 3-4 hours of lessons. Zavi sat in with the pre-K class and Teacher David. The class has about 40 kids in a room the size of a tiny bedroom. They sit about five to a bench. There is no electricity - an open, paneless window lets in the light; lessons are drawn on burlap sacks that are hung from the walls. Each kid gets one pencil and a couple of scraps of paper. The playground consists of a dusty 'yard' with a makeshift climbing structure and some hanging chains that some of the kids swing from. Compare this to Zavi's fancy classroom and playground at the International School in Harare - it's about as opposite as you can get. Still, it's a great opportunity for these kids who couldn't otherwise afford to go to school (or even eat regularly.) The school is free for them - completely funded by donations. The kids are learning a lot, and are so well-behaved. Zavi joined them enthusiastically the first couple of days and it was so cute dropping him off. 'Bye, Mom, don't worry, I'll be fine!' Of course, he kind of stands out in class - with his lack of uniform, lighter skin, longer hair and taller stature. But he did greet them in Kiswahili - Jambo! Habari? Mazuri!

My mornings at the district hospital were educational experiences, too. This isn't the small, private hospital on the grounds of our compound, but the huge regional hospital that is filled beyond capacity. I have visited other hospitals in Africa, India, etc., so knew what to expect, but it is still shocking comparing a 'third world' hospital to what we have at home. It is unbelievably overcrowded, underfunded, sparsely equipped and with an overpowering smell that can't even be described in words. No cameras are allowed in the hostpital, of course, but I won't soon forget some things that I saw. It's hard to find the adequete words to describe the sight of a 600 gram (about 1.3 pounds) baby. Or a little boy with a face burned beyond recognition and no lower lip trying to smile. Or an oozing machete wound. Or a case of genital warts so bad, it's unrecognizable. Or a group of children that now live full-time at the hospital because they were abandoned by their parents there. Or beds and beds filled with malnourished, wasting babies. The hospital has 300 beds, but there are over 600 patients staying there - meaning there are 2 and even sometimes 3 people per bed. Each ward has about 40 beds, as well as people sleeping on the floors. It's dirty by Western standards and, as previously mentioned, horrible smells permeate the air. The monkeys that hang around outside have to be kept at bay and the doctors, nurses and staff make due with minimal equipment. Considering what they have to work with, the patients get remarkable care and the doctors and nurses really know their stuff. I got to tour the facility with one of the nutritionists and I learned a lot about the treatment for kwashiorkor and marasmus (the major malnutrition diseases,) how to make the mixtures, feed the babies, etc. It's one thing to teach about malnutrition in the classroom like I do in Seattle, it's another thing to research about it like I did in Zimbabwe, but another thing entirely to see it first hand... Unfortunately, Kenyans not only suffer from malnutrition, but obesity issues as well. Being fat is considered a show of wealth and is the most desirable body type. SO, where people on the lower economic scale suffer hugely from malnourishment, those at the more affluent end suffer from OVER nutrition issues like diabetes, heart disease and hypertension (much like we see in the states.)

I also got a chance to guest lecture to the girls at the high school at Sister Freda's compound, which was really interesting. They wanted me to talk about health and when I asked the girls to define 'health,' they all said FAT! Fat equals health. We talked a lot about body image types and the difference between African and American ideals. We discussed the health issues related to not having enough body fat and those related to having too much. They were shocked when I told them about eating disorders that are prevalent in America - they had never heard of such things. More interesting discussion ensued regarding nutrition, puberty, self-esteem, etc. They were really open to participating and I think the talk was enjoyed by all.

Unfortunately, I can't say the same about the talk I gave to the nursing students that same evening. I was asked to speak about nutrition, but you could tell that none of the students actually wanted to be there. It was eight at night and they had been working at the hospital since 6 am. Though I tried to engage them, most were falling asleep or texting and I felt like a comedian in a room where nobody laughed (cue sound of crickets chirping here.) There were a couple of students who asked a couple of questions regarding nutrition therapy, but otherwise, it was pretty much a waste of time for all. Oh well :(

On Wednesday and Thursday, I got to travel to some tiny villages and work in the outreach clinics with the doctors and nurses from Sister Freda's hospital. There are so many impoverished places around and they do a few of these clinics per month. For most in the villages, it is their only chance to see a medical professional (the clinics are free for them) and they only get the chance every other month or so. There was also a group of volunteers here on a mission from California, so we had a lot of workers. Though our motivations for being here are quite different and there were a few conversations I had to walk away from, I met some really nice people from that group. Some of them were first time visitors to Africa so I enjoyed hearing their take on things as I'm quite jaded. Seeing this place through unjaded eyes (the excitement of the screaming kids, the wonderment of the nature, the surprise at the poverty) is always a good reminder. Zavion couldn't join us, so he stayed back at the compound, went to class in the mornings and played with the kids and animals in the afternoon. I was nervous leaving him alone, but he was fine. He's showing a new level of independence and everyone really watches out for eachother. Here, they live the adage of 'It Takes a Village!"

The clinics were remarkable learning experiences. On Wednesday, we headed to a makeshift town called Bosnia. It's mostly a resettlement camp for people escaping the tribal skirmishes in the border region. There is another one close by called Kosovo. Bosnia is comprised of small huts nicely situated amongst the trees. There is no electricity and one pump for water. We were instantly mobbed upon arrival and, before we knew it, we all had babies to hold and kids to play with. The clinic lasts for several hours and we were kept busy, busy, busy. Jobs included counting and dispensing medicines, removing jiggers from kids' feet, helping in the injection room, controlling the crowd, helping in the eye clinic (one of the California visitors is an eye doctor and brings his own equipment and tons of donated glasses,) etc. The hardest parts were the crying children (one little boy had over 30 jiggers dug out of his foot,) the wounds that were beyond healing and all the people who had to be turned away at the end of the day. It wouldn't matter how long we were there, we'd still never see everybody. The best parts were the people who were genuinely helped - walking out with new immunizations, loads of medicines or brand new eye glasses, being able to see clearly for the first time. All in all, it was a great, though exhausting, day, but I couldn't wait to get back to see how Z had fared. I had been gone nine hours!

Looking at themselves on a camera

Sister Freda advising a patient 

The jigger removal room

The line of people waiting to be admitted

Zavi was fine. He went to school in the morning, then came back to our room and played Legos. He had lunch with the other kids and played with the kittens. He even found the one TV on the entire compound and was watching Tom and Jerry when I found him. He's nothing if not resourceful. I asked him how his day was and he said, 'fine, but it was weird without you.' 'How was school?' 'ok, but the kids were freaking me out a little. They kept poking at me and stuff.' 'What did you do about it?' "I told the teacher and he hit them on the head with sticks until they stopped. Later, I was a little bored so I left early.' Hmmmmm... He was very interested in hearing about my day, though, and asked me to tell him everything I saw/did at the clinic (and at the hospital earlier in the week.)

Another clinic on Thursday. Even further away. Zavion was still in bed when I left with instructions to get dressed and head to school when the alarm went off. One lady on the compound, Emily, was to escort him to class. He seemed a little sad when I left. We drove to the top of Mt Elgon - a beautiful, though kidney jarring and stomach turning- ride. The village was even smaller then before and the area is pretty sparsely populated - people walked for miles to get to the clinic. It was still busy, but less chaotic. We did more of the same - counting medicines, washing feet, holding babies, giving shots... At the end of the day, Sister Freda was checking out a very sick child and told the mother that if she didn't get her to the hospital TODAY - the child would likely die. She said she didn't have the 1000 shillings (about $12) to be admitted to the hospital. You have never seen a group of teary-eyed Americans reach into their pockets so fast. Needless to say, she got the money and took the baby to the hospital. I have no idea, though, if the baby lived or died. Through these outreach experiences, I am learning a lot about rural medicine- giving me lots of fodder for discussion in my global health and nutrition classes. I know I'm leaving out a lot of details and need to catch up in my journal and take some time to internalize everything...


Counting meds

Foot washing

Love the excitement of the kiddos

Though they weren't all happy to see us... this guy was terrified!

Happy donkey!

When I got back home (10 hours later) - Zavi was fine. He was in our room and said, 'Mom, I missed you google, infinity times, but I still had fun!' So grown up. Although, he decided NOT to go to class - 'I didn't feel like getting freaked out by the kids again.' He played in the room, with the dogs and with Emily. He did make it out to play with the kids for a little while. The room was full of evidence of experiments and inventions he is working on - sticks hanging from various places around the room, a tower made of cookies, new Lego arrangements, etc. He had also walked next door to the small hospital to ask the nurses about his huge sneeze ('Mom, it was the biggest sneeze I've ever had and a bunch of yucky spit came out of my mouth, I had to ask the nurse about it!') He also asked them how to get past level 32 on Cover Orange (a game on his iTouch.) He seemed somewhat distraught that nobody knew what in the world he was talking about. 'Mommy, they didn't understand what I wanted. I was NOT happy as a lark.'. Since he had skipped school, we spent the evening working on his writing and drawing. He now uses both hands interchangably - left hand while writing on left side of the paper, and right on right. There really isn't much difference in comfort or outcome - maybe he is truly ambidextrous.

I stayed at the compound on Friday - no outreach clinic - so I was able to hang with Zavi. The California group came here and Zavion helped give them the tour (was most enthusiastic about the kittens and puppies, of course.) There are a couple of cute, teenage girls in the gourp and Z made an immediate beeline for them. 'Hey - do you want to come to my room and play with my snake?' He was very talkative/ flitatious with them- showing them his toys (and my underpants.) If this is a taste of his teenage years- god help me. We played with the kids some more and then I worked in the eye clinic for a couple of hours while Zavi fended for himself. I did have his eyes checked (they're perfect, whereas mine have slipped a little since my surgery (as I thought) so I now have glasses for driving, movies, etc.)


What to eat when you can't decide between jelly, peanut butter and nutella on your toast...

Saturday was another outreach clinic. This one was even further away. Zavion hung out with Emily - helped her wash the clothes, etc. and Luke McNaughtymaker all day. Meanwhile, we drove way out to the Uganda border north of Kitale. Up the mountains and then back down to the scrubby, sparse, dry and hot home of the Pokot tribe. I couldn't get the Talking Heads' 'Road to Nowhere' out of my head. Where did all these people even come from? They must have walked all morning! The Pokot tribe is dirt poor and pretty isolated from the rest of Kenya. They speak no Swahili, still dress mostly in traditional clothing and are a hardened, proud tribe. The ground here is not conducive to farming, so they are herders - the men being mostly nomadic in order to find the best grass for their goats and sheep - sometimes crossing into Uganda. They were amazing people - colorful, friendly and tough as nails. Caloused feet and hands, lots of beautiful, bright eyed babies tied to the backs of their mothers or older siblings. And totally self sufficient - no cash economy whatsoever. We did the same stuff as before, but each day was a totally unique experience. This one even included spontaneous singing by all at the end. I really wish I could upload the pictures!! I'm glad my time at Sister Freda's overlapped with the outreach group as these clinics have been amazing experiences. I'm also so happy Z was ok with me leaving (and thanks to Emily for keeping an eye on him.)

I was so ready to see him by the end of the day, though, and when I got to the room, he showed me the shrine/present he had built for me out of cookies, flower petals and mangos. 'I made this especially for you, mom!' There was evidence of a nutella splurge on his face, clothes, sink, the wall... but, mostly, he did great. 'Mommy, I missed you, let's snuggle for a little bit.' Last night, after my bucket shower to get the dusty grime off that was covering my body, we headed outside for a walk in moon shadow, some Luke chasing and some toad hunting.

Today is a down day. Taking it easy before heading to another village/project tomorrow. Wonder what it will be like... I've really enjoyed my experiences here and I think Zavi is getting something out of it, too. We are having great conversations, he's found a new independence, etc. He does show his soft, American upbringing side from time to time, though - screaming bloody murder when I remove a splinter from his foot (you should have seen how stoic these kids were when we were digging into their feet for jiggers...) complaining about a 45 minute walk in the sun (The kids here walk everywhere - up to 2 hours to school, etc.) I need to balance my reactions, though. I want him to appreciate what he has, learn to live simply, and reach out to others who have less, but I don't want to have him racked with guilt. He is still so young. This is a lots to wrap his little head around. I have to say, though, that he's doing great and he really is an amazing little person.

Well, I'd better go.

Saying goodbye!!

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