Last Week in Kisesini

This is how we get our milk and mangoes!

Little Nzyoka on his way for and GHP-sponsored ultrasound for his admoninal distention

What a cutie!

Mahindi (Maize) after the rains stop falling.

Waiting in the Syokisinga sun for the hippos

Athi River in Syokisinga. Waiting for the hippos that never came....

Sunrise at the clinic last Thursday

The new Nurse Teresa at the Syokisinga outreach

Depo anyone???

It is true what ‘they’ say- time flies when you are having fun! What a fun and challenging few months! I am going to miss this place with my whole heart. I find so much comfort in the quiet nights and sunny days. This is a unique place where bugs are abnormally large, where the scorpions are not affraid to use thier stingers, where bugs can predict the local weather, where dogs are not pets, and where dic dic meat is a treat. This is a place where the rain is God’s greatest blessing, where the roads can be unthinkably hellish, where the sun show no mercy and clouds are scarce, where the safety is NOT number one, where rules are governed by survival. This place where babies are born in the rain, where AIDS claims lives of too many mothers, where Typhoid and Brucella are a daily lab order, where tetanus shots are handed out like candy (along with the deworming medication), where patients do not know morphine, but rather ibuprofen. This place where the sun rise will bring tears to your eyes, where chipati cures all blues and illness, where people open their hearts and welcome ‘outsiders’ like myself, where a meal is not complete without a little dirt, where you can get 500ml of Senator keg brew for 60kshillings (about 60cents). This place where 26beating hearts can fit into a ’14 passenger van,’ where you can expect the unexpected at each new ‘toilet’, where cochraoches and humans coexist in houses together, where roosters like waking up at 330am, where a meal can cost less than 50cents. This is a place where hauling your own water builds character, where hot showers are made by boiling water on a stove and adding it to the pitcher your pour over your head, where handwash is not a setting on a machine, where they actually ask you if you want your beer hot or cold! This place where I have made my tent-home for the past 6 months.

I spent last week finishing up projects, so that the transition to me leaving will be as easy for Vincent and Nicholas as possible. I was able to catchup with a baby that we started on milk formula supplement becuase his mom died from AIDs complications. His aunt was caring for him with goat/cow milk up until the point that she brought him in. Amos has been growing amazingly well over the past 2 months now- he has gained almost 2kgs! He is also catching up on some milestones that were lacking (social smile,etc). He is a beautiful little boy with a bright future ahead of him, thanks to the formula support of GHP. It is really expensive here and cannot be afforded by most. Goat and cows milk are a poor substitute, as was demonstrated by his lack of milestones and proper growth. What a blessing to see him actually almost have a double-chin, just like babies should have! I really wanted to bring him home, but not sure it would fly with the folks I hear that they are a bit more time/energy-intensive than dogs.

I spent my weekend doing my final outreach in Syokisinga. I gave a record number of women depo shots! YaY! We had 7 children put on unimix (moderate malnutrition) and 3 put on plumpinut (severely malnurished). I think it might be due to the lack of continued rain that came down so heavily in Oct/Nov…a lot of crops died before being able to produce much.
I then went to Machakos with Vincent, where I was able to say my goodbyes to the wonderful nurses and clinical officers I have met in the past few months.

I will be leaving on Friday to Doha airport (with an 8hr layover!), then to Washinton DC, and, finally, HOME! I am really looking forward to the redchile cheese enchilada that my mom promised me….

Thanks for following the blog! I have really appreciated all the comments! THANK YOU! I will post some pictures when I get back to the states (chances are good I will have uninterrupted high speed interweb!) ha ha.

PEACE.

Beach Mini-Vacation

Crabs!

Sand biking...tough

Sunrise at the beach

Practicing with the snorkel

Life is good

Vincent with a sea spider and starfish

Vincent and ME on the beach

Riding bikes around Diani Beach

Looking for shells

Coconut trees

Vincent head-first down the slide at the pool

THe Columbus monkey found on the South Coast

Fahd (an old friend of Vincents) and Vincent at the beach near Mombasa

This is an albino child near Kisesini, she is also on the unimix supplementation, as she is malnurished. GHP supplied the medicine to treat her skin infection

This is little Naomi, who was the first child put on plumpinut for sever malnutrtion by GHP a few years ago, at the very first outreach. She is now a happy and healthy 4yr old

Baby Amos, who is growing well after being given milk supplement by GHP after her mom died of AIDS complications

This is little Nthenya, who showed us to her own house last week. What a doll!

An agriculture group laying pipes for water/irrigation

One of the agriculture groups taking a break from working on the shamba

Updates from Kisesini:
1. I have started my 3rd woven basket!
2. I have perfected mboga (cabbage with potatoes, tomatoes, bell peppers and onions)
3. I have officially seen one patient with confirmed malaria, one with typhoid and one with brucella.
4. I can’t believe that certain things have become ‘normal’ like ahnd washing clothes, hauling water from a large tank and sifting through rice for rocks, etc.
5. I continue to fall in love with it here and it will be tough to go home

I was fortunate enough to spend last weekend in Diani Beach (just south of Mombasa). Vincent came as my body gaurd, as I would have never taken the trip alone. We were able to go snorkeling (Vincent’s first time) and the guide had us holding these sea spiders that were so creepy! We ate seafood and Indian food-there is a huge multicultural infuence becuase it is a large port of entry. We saw monkeys and rode bicycles around. It was a really wonderful min-vacation. The weather is HOT, but I completely recommend it for anyone looking for an amazing beach!
I am now starting to wrap up my projects and train the CHWs to do the work I was doing, including weighing children. It is crazy to think I only have 3 weeks left!
We have gotten a new nurse in Kisesini- She is Teresa and she is so great! Everyone is hoping that she will stay (many nurses have been appointed there, but leave when they see how isolated/rural it is). So far, she seems to like it!

Christmas Kenyan-Style

This is Tomed (named after Dr. Tomedi who deliver him and his twin)...he peed on me while I was watching Christmas choir practice with Ann (he was sound asleep)

Kids being Kids

Boys that Ann and I found skinny-dipping in the river (of course they threw their clothes on as soon as they saw us)

These are some of my young friends out in Syokisinga. They are so cute and their English is fantastic

This is little Wambua with Rickets, he is treated with medications provided by GHP and is now doing much better.

Ann blowing up a balloon for baby Kalonzo

Baby Kalonzo and Faith with their mother. This is one of the families supported by GHP in the food program

Maize is growing tall. Justine and Ann on a Sunday stroll

A snake bite

This is Baby Kuvuthi who is supported by GHP for her milk formula, as her mother is unable to breastfeed. She is now catching up on her growth milestones and has the most beautiful social smile!

Seriously catipillar invasion 2 weeks ago for 3 days...EVERYWHERE!

Nures Nicholas distributing the Christmas food for 11 of the poorest families that GHP supports

Kiya, on her visit to MAchakos from Nairobi, with our fruit dish

Vincent, Kiya, me, Jima and Juka (from Japan) on Dec 23rd

My US friend, Kiya, who is stationed in Nairobi (I met her in the immigration office)

Nichlas, Jusinda and Baby Vale on Christmas Eve in Wamunyo

More goat meat...

Vincent with Christmas Goat Meat

Vincent and Me waiting for the roasted goat meat!

Amigo, Vincent's cousin, and me in Tala on Christmas!

Vincent and his cousin, Amigo, in Tala

A CHRISTMAS RAINBOW above Vincent's head!

Freshly showered waiting to make tea at Vincent's house Christmas morning

Here is one of the little guys that causes a great deal of pain- he is about the size of a deck of cards

Hiking around with CHW Mutinda (if you look back at my first post from this trip you can see the incredible night and day contrast of brown and green!)

I hope that everyone reading this had a wonderful Holiday Season and a fantastic New Year! I have been busy and the internet connection has been terrible! Sigh….can’t wait for high-speed (or at least internet that is a bit more reliable)
I met with my new American friend, Kiya, in Machakos on the Thursday before Christmas and we had a blast. We enjoyed a bit of shopping (we bought matching africa necklaces as presents to each other) and some goat meat. I am starting to think that they put something in that meat- both her and I are addicted now! We spent Friday with a bunch of friend in Machakos and went to a few local spots for a Tusker and dancing. Boy do these Kenyans know how to dance! It was a real treat spending time with someone from home- we were able to talk about anything and everything. She is working in the television business and doing really well fitting into the media groups in Nairobi. I met at the beginning of December in the immigration office. We became official aliens together! Saturday, Christmas Eve, we parted ways after we ate a Christmas coconut.
I was able to spend Christmas Eve at Nichlas’ house for his daughters birhtday. Vale is 2yrs old now and speaking some English, some Swahili and some KiKamba! Very impressive little one and adorable. I was able to try some of the local brew with some of the old men of the family and I was offered meat from a goat’s head-I kindly declined. I have not been able to swallow the idea of eating the head or the intestines (which is in high demand here). We packed up and headed back to Machakos to prepare for the trip to Tala for Christmas.
I spent Christmas in MAchakos with Vincent and his large family. We ate more roastde goat meat, chipati and getheri (corn and beans). We walked all over meeting new friends and family. Everything is a bit more green in Tala- the trees are a bit bigger and they are able to grow coffee. It is really a loavely place. It has been really fun experiencing different houses in different part of Kenya. I am amazed at how different they are. Vincent and I headed back to MAchakos the day after Christmas to prepar for the trip back to Kisesini.
The week after Christmas was busy with weighing more babies and arranging meetings with the cheifs from each sublocation to explain the upcoming projects (there is a group of 12 medical students coming after I leave in March to start a few new projects). Clinic was crazy with a few births and many skin/rash problems. We have seen a few more cases of BRucella, typhoid, and giardia.
Good news! The motorcycle is back up and running…slowly. I have taken a few trips on it now and the trick is to go slowly! Ah! I love that bike very much.What a trip.

I will write more soon (the internet has been terrible!)

More Pictures

Knock First, Love...I love this door.IT is at the front of a hotel and I see it everytime I go out to Syokisinga to weigh babies

Baby Sam (happiest baby ever), Rhina (SAm's sister) and I eating sugar cane (which grows like weeds there)

This is Sam. World's happiest baby! He is the son of Justine's laborers in Luuya

Jusinda (right) and Neli (left) doing laundry in Luuya- Neli is 7yrs old. Impressive

Justine and Me picking groundnuts (peanuts) off the plant at Luuya (Western Kenya)

Neli playing with a hat she had when she was a baby. So cute!

The green reflection on Justine in her homeplace.

Flowers are beautiful in Bungoma (Western Kenya...about 45minutes from Uganda border)

CHW Alice teaching Scolastica and Mercy about infant nutrition and breasteeding

One of the sgriculture groups enrolled for education and a revolving loan from GHP...with the idea of flooding the market and decreasing prices in Syokisinga

Wambua, from the Ministry of Agriculture, teaching the agriculture groups about finances and proper crop growing

I left off last week after my trip to Bungoma/Western Kenya…
I spent the week after my visit to Western weighing babies and helping Vincent and Nicholas in clinic where ever I could- mostly in Maternal/Child Health doing immunizations and weighing babies. I think it is my favorite place in the world- these beautiful children under the age of 5yrs pile in with their mothers and wait patiently for me to go through their ‘health passport’ to see what immunizations/medications are needed. I have been giving a lot of oral polio vaccine, BCG vaccines and the Pneumococcal vaccine. I think that I hate the BCG the most- it leaves a scar on the left forearm of the babies and I feel bad. I get to tell the mothers how beautiful and intelligent their children are and see thier face light up when I can’t get enough of their child….it takes me a long time to finish one child. There is also a lot of paperwork to do, I am learning. I feel bad for Vincent and Nicholas- it is very repetative and takes forever.
I went out to Syokisinga a few times for newborn weights and the yellow bomber (my motorcycle) was reliable up until Saturday, when it died completely on my way out to weight a newborn. What a frustrating experience! Thanks to Vincent (and his phone) I was able to secure a driver, get someone to take the bike to their home so that parts would not get stolen and was able to meet the CHWs. I then went to MAchakos to meet Vincent, as he had also invited me to his homeplace, called Tala.
Sunday, we got up early and took off…along this amazingly gorgeous road up this green hillside. We hit a dirt road..a terrible dirt road…that continued for way too many kilometers (mom, you would have been proud- I did NOT get carsick!). Apparently in the government books, it is paved…I think someone in the area is walking around with a chunk of ‘pocket’ money from it.
His family was so welcoming- they walked me all over their shambas. I learned avacados grow on trees (yes, I know most people know that…) and coffee season is in January/February. We ate ugali, rice, ghetheri (beans and corn with cowpea leaves) and goatmeat stew. I learned that it is tradition to take the mother tea laves and sugar if you are a guest (I was prepared for that one) and the son/daughter visiting picks up a bunch of food items- flour, sugar, rice, oil, etc.
We spent the day walking around his home and went to meet his dad for a Tusker before leaving back to Machakos. It was a beautiful sunset drive home…with a packed 8-passenger car (carrying 15beating hearts).
This week was spent entering data into our under 5 database and weighing babies. We had a guy come into clinic with a scorpion sting- he was way worse off than I: his was blistering and more swollen. Instead of a shot in the butt, he got IV steroids to help with the pain/swelling. I went Friday to meet with the poultry group in Syokisinga. Wambua, from the ministry of agriculture, is teaching both the poultry and the agriculture groups all that they need to know to succeed with their revolving loans that were given out by GHP. I can’t wait to see the chicken houses and all the chickens when they are done!

So…I have not written poetry since high school and I don’t use the left side of my brain regularly. However, my current surroundings seem to be best decribed through poetry, as it is too overwhelming,beautiful and powerful to cover in a normal paragraph. I apologize to all those reading who are literary/poetry experts…I am certain this poem has broken some language/poetry rule….but here is my attempt at describing the amazing changes in the past few weeks since the rains started…

Maji ni maisha

Young mouths with a hungry cry
For food that the earth cannot produce
The land has become barren and dry
Trees begging for the taste of rain

Maji ni Maisha, water is life

Each dropless day brings more loss, suffering and pain
Children desperate to feel satisfied and full
Thousands of unanswered prayers, each one for rain
That refuses to fall from the blue, sun-filled sky above

Maji ni maish, water is life

One blessed day, grey clouds covered our heads
Spilling the sweetness of energy from the heavens
Every plant growing from the brown it has shed
To the beautiful, deep green of happiness and content

Maji Ni Maisha, water is life

Insect and animals with noises that were once silent
Followed close behind by a new generation
Clouds continue with thunder so violent
And flowing rivers that makes music for all to hear

Maji ni maisha, water is life

All shambas once harboring death and left untilled
Now birthing green crops that will supply
Fuel for the children, now with aching bellies filled
Life and happiness, noises and content
Maji ni maisha, water is life

I wish you all a very blessed and happy Christmas season.

Peace.

From ‘Visitor’ to ‘Alien’

Ann at an outreach in Mekilingi- we might have been a bit big for the toys...

Our driver, Mula (when it is muddy) and Ann hanging out waiting for an agriculture project meeting

A very fun painting on the side of the primary school in Mekilingi

Colors other than brown! The ground is alive now!

Ann playing with my camera while we wait for the meetings to start- SO GREEN in the background!

So, it is Official! I have been here 3 months and was required to visit the office of immigration in Nairobi for an extension on my Visa. I went last Thursday and went from being a ‘visitor’ to an ‘alien’- I have an official card and everything.
Prior to obtaining my Visa in Nairobi, I had quite the experience with the local ‘wildlife’ on Tuesday evening. I had come back from a long day of attending agriculture classes and infant nutrition courses in Syokisinga and I was making a cup of tea. The clums me that I am, I spilled on the floor. I went and grabbed the rag from outside and filled the bucket with water and cleaner. I started ‘mopping’ the floor with the rag when I felt a thron of some sort. I thought ‘those thorny bushes have finally gotten me!’ As I looked at my hand to assess the damage, a scorpion crawls out from the rag. Oh my god! In my head, all I could hear were some of the locals telling me that the scorpions are poisonous. Turns out, they are not life-threatening poisonous….however, they are the kind of poisonous that gets you a cortisone shot in the butt and makes you wish that they were poisonous, to end the pain. It starts like a thorn prick whereever it stings you. Then, slowly the burning radiates through your blood stream. I got stung on the finger and about 30minutes later, I could feel the burning in my shoulder. Then there is this pulsating pain deep inside. After the initial burning, the pain is similar to the pins and needles sensation you get when your arm goes to sleep…but it does not stop…for about 24hrs. Worst pain I have felt. Vincent was really nice that night, he brought home goat meat and Kenya Cane (a spirit). We wathced a bootleg movie on his computer, as he was trying to get my mind of the burning pain. By 5pm the next day, I was fine and a lot more careful when picking up rags and such. Lesson Learned.

Wednesday was spent in Syokisinga weighing a baby and running some errands for the project. When I got home, I started packing for my trip to Western Kenya with Justine and her 3 children. It is Justine’s homeplace and she had invited me a few weeks back.
Thursday morning we began the LOOONNNG Journey bymuddy motorbike ride to Kyua (about 30minutes). From Kyua, we took a matatu (bus/van) to Nairobi (about 4hrs). We then spent the afternoon at the Office of Immigration getting my Visa renewed- government offices everywhere operate at a snails-pace. I waited for almost 4hrs before I was ‘apporved.’ While I was waiting, I met a girl from Minnasota- Kiya. She just graduated from undergrad with a degree in media and she was starting a fashion television show in Nairobi. We really hit it off and bonded over our stories from the past 3 months. We exchanged Kenya telephone numbers and, by the end of the 4 hrs, everyone in the office thought we had come together so they let us get finger printed together and such. Really a great encounter. We were talking about spending the holidays together. That would be really nice to having someone to share it with!

After the immigration ordeal, we headed over to the bus stop for our 8pm bus to Bungoma. I thought a night bus would be great…I was incorrect. It is so hard to sleep and I get carsick, so the combo was not great. We finally arrived in Bungoma (about 1hr from the Uganda border) at 5:45am. We grabbed some chai tea and Mdazi with the kids and starting heading to her home. We took a 20minute van ride to a dirt road and then a 20 minute motorcycle ride, in the mud (Western Kenya is know for their year-round rain), to Luuya. I was now surrounded by people from the Lua tribe. IT was great to hear another local language- very different than Kikamba. After arriving at the house, we took a tour of her shamba- with HUGE sugar cane, groundnuts (peanuts), and cowpeas. It was SO green and the plants grow so well- especially sugar cane and bananas! We set to work on a pile of groundnut plants that had just been pulled. We removed about `5kg of peanuts from the roots. It was such a fun job! We made lunch and settled into the house, as the rains ALWAYS come down hard in the early evening. I helped Justine sort through the rice and green grams that we were going to prepare for dinner and the kids studied (Justine makes them read on their vacation time, which is really great and the kids actually like it!). That night we snuggled in our bednets and listened to the rain come down for hours.
The next morning we spent in the town of Bungoma, getting food for Justine’s mother and family. We headed to her birthplace/mother’s house of Tula. It was beautiful! Her mother, sister and brother (all with families of their own) were so welcoming and wonderful. It was such a great experience to spend time in a person’s homeland. We went to her cousins wedding and then headed home before the rains could get us. Her mother gave me 6kg of groundnuts and two beautiful plaques as a gift for being her guest. I was completely impressed with the generousity.
I headed back on the DAY bus on EasyCoach on Sunday and was far less carsick AND I got to see Zebra, Baboons, monkeys and Gazelle as I was passing through Nakuru and Naivasha on my way to NAirobi. I arrived at Nairobi and met my friend/tutor Joseph for some Somosas and sodas! He got me safely on the matatu to Machakos, where I spent the night with the nurses. We made it back to Kisesini Monday morning and had a VERY busy day of clinic. I saw lots of jimbe (a hoe) and thorn accidents, chickenpox, backpain and common cold.
Tuesday I was in clinic again, as Vincent was in a monthly meeting in Matu and Nicholas was in Nairobi trying to get the ambulance fixed. I saw 38patients in 4 and a half hours. It was nuts! I have seen a lot of dermatological diseases (IMPETIGO is everywhere now!) in kids and I am getting really great at differentiating typhoid vs malaria vs chornic backpain/joint pain. I love when kids walk in the room- that is how I know that I am meant to be a pediatrician. After a busy day without lunch, my interpreter, Ann, and I went for soda (KRest) and chipati! I then remembered that I have been put incharge of Justine’s chicken while she is still away at her homeplace in WEstern Kenya….so I relaized it was getting dark and I needed to put them in their appropriate roosts….not as easy/simple as it seems. Some mother hens don’t like other babies, so you need to make sure the right babies go with the right hens or you end up with dead baby chickens . I think I have done ok for the first night….
Wednesday was another day in clinic with Vincent. I saw more impetigo in children, Jembe accidents and backpain. I saw a patient with panic attacks and it breaks my heart that there is no medication. I just had to advise him on how to deal with them. Very sad. Ann and I went for our daily chipati and soda for lunch- Ann (the hotel/cafe keeper) and her husband, Mutua (who is also the night guard) have now started bringin our 2 chipati on 1 plate. It is really a comfort. All the kisesini locals call us sisters because we are ALWAYS together (even days she does not interpret for me) and ALWAYS laughing. It is rare to get such a great connection with someone. I feel at home here and I love it! I made dinner of beans and rice…reminded me of Mexican food at home! I put hot suace on top and pretended I was sitting in front of the fireplace with Christmas lights all around me…then I looked around and I was surrounded by a nearly-full moon and beautiful stars…a decent exchange.
Thursday was clinic in the morning and weighing babies in the afternoon. Ann and I hiked out towards the main road for about an hour, weighed a 3hr old baby, and hiked back. On the way to the baby, we passed a house where I heard ‘Sydney, Sydney, how are you?’ I was SHOCKED! This was the first time I have heard my name when I have been away from Kisesini. It was a bunch of young children who I had seen in clinic at different times. It was such a good feeling. I was not just the ‘muzungo’ I was ‘Sydney’ So great. On the hike back, we ran into a group of boys skinny dipping/rock jumping. It was so funny to watch them all scream and run when they saw Ann and I! They were laughing hysterically and were all naked! So good to see kids being kids. Afterall, these children work on the shambas most days, just as an adult would. It warmed my heart. We got back and I bought dinner items- cowpeas (as you cannot get sukumawiki this time of year because EVERYONE has cowpeas growing in the shambas), onions, tomatoes, bananas, and green grams (lentils). Yum! Dinner! Vincent and I sat down to watch a bootleg version of ‘Grown ups.’
Today started out with a motorcycle ride (the first without mud!!) out to Syokisinga to meet Kamau, one of my favorite CHWs! He is about 68yrs and acts like he is mid forties! When we met, he took over the drivers seat on the motorcycle and drove us over some of the roughest terrain! I was impressed and VERY scared at the same time….Kamau is several kilograms less than I and he had a bit of a tough time handling the bike. Oh well, we made it through the day, that is what matters! We took a quick break at lungh time for mandizi (sort of like a sopapilla) and soda. He invited me into his home (a first!) and took me on a tour of his shamba. I was really touched. He is so sweet! We invited me over in 2weeks with the peas are ready for harvest! I can’t wait!
I could only upload a few pics this evening…I have many that I want to share…I will try to see if the internet is better tomorrow and put in a another blog post!
May everyone have a blessed and safe holiday season!

Kenya is Full of Surprises!

One of the mothers and babies (Brian) that I weighed last week

The flowers are starting to come out!

Ann and I making chipati!

Justine, Catherine (neighbor), and MY CHIOKEN!

More learning:
1. Rain is beautiful
2. Nothing feels better than being invited back to ‘the home place’ of locals
3. I had no idea that the bugs could get as big as they are…seriously, there is something in the water here. Kind of creepy.
4. Everyone should have their own chicken
5. The happiest feeling in the world is knowning where your heart belongs.

While I was not able to enjoy Turkey on Thanksgiving, Nicholas was kind enough (after I explained to him about our Thanksgiving Day) to find a delicious substitute: dik-dik meat. He knew that I had been wanting to try to meat for a while and that there is almost no access to turkey. The dik-dik is a small, deer-like animal that roams this area. They are very fast and, I would imagine, difficult to hunt. Many of the young boys in this area make money by hunting and selling the meat…turns out it is similar in taste to elk meat (AKA DELICIOUS). They made a potato-dik-dik soup that we put on top of our rice. So good and I was able to eat it with my Kenyan family- Nicholas, his wife (Jusinda), Vincent and Justine. So fun! Here is some info on the ever-delicious little animal:

http://en.wikipedia.org/wiki/Dik-dik

I spent Friday night in Machakos at a local bar with the Kisesini crew. It is always nice to take a break from the VERY rural Kisesini and enjoy lights and a cold beer and somosas! I came back Saturday night after solo matatu ride and motorcycle ride through the mud with my favorite driver, Mula! It always feels good to make little accomplishments solo. I also found some friends I knew from Kisesini along the way in the matatu- it is amazing how small-town this place is. It is probably not hard for them to pick me out of the crowd, as I am the only Muzungo for about 60km.
Today, I made Justine and her kids donuts and did some laundry….and I BOUGHT my FIRST chicken! It was a small hen that should start laying eggs in about 3weeks (that is per Justine, who is a chicken expert!). I am so excited. If we don’t eat it before I leave, I am giving it to Justine. Don’t worry Mom…no live animals coming home with me! I can’t believe I just paid $2.00 for a hen! This place is great if you are on a budget. I helped Justine plant some sweet potatoes today and cleaned the house. Pretty relaxed Sunday, which is how it should be.

I will be joining Justine and her children this weekend to her ‘homeland’, which is north west of Nairobi, near Uganda. She has invited me to ‘help work on the shamba’ and I could not be more excited! Nicholas has made sure I am packed with a treated mosquito net, as malaria is prevelant up in the tropical area. I am thrilled to be seeing another area of Kenya. I have also been invited to Vincent’s homeplace, which is a bit north west of Machakos. I am excited to go to his mom’s shamba, as she grows coffee! The best plant on earth. It will be really nice to meet families and spends some time with another tribe (Justine is Kikuyu) outside of the Kamba, as I know I will learn a lot!

It looks like it is going to rain hard again tonight…looking forward to the adventure that will be tomorrow.

Thanksgiving…

Baby Faith

I have had a great week filled with weighing babies and clinic time. I spent last weekend helping Justine and her three children making a shamba (farm) outside her house. Talk about tough work! The Jimbe (hoe) is especially difficult. We planted cassava root, sweet potatoes, cowpeas, beans and maize. It should all be ready just about the time I leave to come home. It has been amazing to see all the shambas in the area grow green and the maize grow tall!
I spent Monday weighing a baby and a bit of time in clinic. I was suppose to go out to Syokisinga, but it had rained nonstop all Sunday night, so I did not think it was safe…as I could only imagine the road being worse than the other times. The baby that we went to visit (close to clinic) was healthy and happy. I learned that they stick a piece of paper on the forhead (in the picture) for prevention of reflux.
I spent Tuesday doing about the same thing with another baby. I met a woman (traditional birth attendant) during the visit, who is well-known throughout the region and has many women come to her for delivery. I spent some time talking with her about how they clamp the cord (with string) and how they cut the cord (new razors). It was really fascinating. She welcomed me openly into her home and said she would be calling me for all the deliveries she recieved. I love helpful people!
Wednesday was clinic day, as Vincent is on vacation visiting his mom…not any normal sort of vacation, either. I talked to him last night and he had just finished weeding several acres of his mother’s shamba…and I thought I had it rough when I went home (just kidding, mom and dad!). Nicholas needed to go to Machakos for clinic busniess, so I was left with Justine, Nduku (the pharmacist), Anne (my fabulous interpreter) and Elizabeth (the registrar). The morning started with 2 rabies vaccines- Last Thursday I saw an old lady who was bit by a dog and rumor had it the dog also bit a little girl. The son of the old woman killed the dog, but I was not taking any chances, so we took them to get the VERY expensive vaccine in Kituii. They need at least 5 vaccines (day 0,3,7,14,28 and WHO reccomends day90). YEsterday, I gave them their 3rd injection. As I am saying ‘Pole sana’ (very sorry), the old woman is telling me ‘asanti sana’ (thanks a lot)….her son was laughing as we came back into the room listening to us. The little girl is such a champ. She takes the shots better than I have seen most kids. What a trooper! Her bite was also infected, so I put her on antibiotics. It was back to patients with Hypertension and stomaches…until a lady in her late 20s came hobbling in off a motorbike with a lasso(small piece of clothe) wrapped around her left leg- NEVER a good sign. I took her straight to the Delivery/wound cleaning/injection room and laid her down, as i was not sure how much blood would come pouring out. As I undressed the wound, she told Ann that she was plowing and the plow popped out and cut her leg. Sure enough the wound was deep and bleeding a lot. Nduku gave her a shot of TRamadol for the pain and we set to work on cleaning it out. After digging through the wound to find the skin, I was able to stitch her up with 10 Nylon stitches. I felt so bad for this lady. She was amazing. I saw a woman with Cellulitis of her breast that was so tender and painful- I felt so bad for her. I had lots of kiddos with superinfected chickenpox. I found a pretty significant heart murmur in a 16yr old boy and we had to refer him to a larger facility. I had a little girl with Type I (juvenile) diabetes come in with a sugar through the roof. I got Nicholas on the phone and we talked through a game-plan of giving her insulin and watching her. We were able to get it under control and send her home by 630pm…he dad brought her on a bicycle from VERY far away. I admire that father and his dedication to her health. Wow….
So it is now TurkeyDay..not my typical Thanksgiving Day, but I like it here, so I am not too homesick. As it is tradition, I would like to give a list of things I am thankful for:
- My supportive, loving, crazy family- I love everyone of you for everything you have done to support me through school, work and life. I love you all! Mom and Dad- you all are the bestest and I miss ya! To all my grandparents- I could not have made it here without all your birthday cards, M and Ms and rafting!To my brothers, who have made me a stronger person To my Aunts, Uncles and Cousins- you are all so wonderful!
-Friends who I cannot imagine life without and who have also been super supportive of me in all my questionable decision making.
-For my mentors, like Dr. Tomedi and Dr. Neal, who continue to inspire me and drive me to my professional and personal goals!
-Ice cubes, ICe cream and laundry machines
-A mattress, Cold Blueberry WildDog, paved roads, chocolate, and a pretty solid healthcare infrastructure (comparatively speaking)
-My oven for baking and my electricity that does not require sunlight

I am stopping there before this list turns into a novel….

I wish you all a safe and Blessed Thanksgiving Day!

It is all part of living

Children of one of the poorest mothers in Kisesini

Beautiful water (maji smart)

I was asked by a mother to help weed and I was more than excited! Gotta love yard work

Wambua, now off unimix and growing nicely

Wambua, again, showing us how the measurements are done. He is such a cutie!

Baby Damarus...I wanted to steal her, but the grandmother had a watchful eye

An adorable smile from this little one before he got weighed and measured! Such a champ!

This is the River Kamau and I crossed in our motorcycles...these are two VERY old men who helped So cute!

Ndulo- Cheka kidogo Ndulo (smile!)

River crossing by motorbike...scoping it out first...

outside my tent 5 days ago

It has been a busy week and a half. It has been over ten days since my last post. There are several reasons for this: when there is rain, there is no sun. When there is no sun, there is no power. Bummer. Electricity is a luxury. It has also been a busy 10days. Let’s see….
Last week was filled up with follow up on children in the area who have been on unimix and plumpinut. We had some really adorable children and I was able to see, first hand, the positive growth and development of children who were well under their average weight for height. Unimix and plumpinut are magic! Tragically, we had one child die from malnutrition last week. It was the child I previously posted with Marimus (acute severe malnutrition). Several of the children were now in school and doing very well. The parents were more than grateful and happy to let us weigh and measure their child. While walking through the Kyua sublocation, we ran into families weeding their shambas and children working right along side them (children as little as 4yrs old). It was amazing to see such an incredible family effort in growing food. One of the women asked me to join…and Nick and Ann laughed as I dug the weeds like it was nobody’s business! It is really great exercise, too. I will admit, I was sore the next day.
I got to do a bit of work in the clinic. Still seeing chickenpox, back pain (I would have back pain, too, if I spent hours in the shamba diggin weeds), diarrhea and infections.
Thursday night, we had a going away dinner for Nick, as it was his last day here in Kisesini. We drank wine and made pasta with a tomato sauce…kind of amazing. We took Nick to Machakos on Friday where we spent the night at a place called Wizard’s Point. We enjoyed COLD fermented malt beverages and chips (french fries) and somosas! Saturday was spent running errands around machakos. Most importantly, I found some chocolate and bought ‘top up’ minutes for my phone, so that I could call home. We also found a place that sold Pizza! Shocking! Considering most Kenyans think it is gross to eat mold. They have a good point. I will continue enjoying my cheese, though. We took Nick to Nairobi after having several run-ins with the local, Machakos drunks. We found his bus to Cimpala and left to find dinner….more somosas and french fries
I spent the next few days with Vincent and Nicholas in Machakos, as they wanted me to travel back to Kisesini with them and not alone. I found myself on Sunday night eating Japanese food made by 2 Japanese women (or the closest that they could get with ingredients that they could find) and wathcing a Horror film, the Descent, at Vincents’ cousins apartment. It was a great experience..there were 4 languages spoken that night- Kikamba, KiSwahili, English and Japanese. Truly blessed for the experience. The two Japanese women were working for an NGO that helps drill bore hole wells, which are vital to places like Kisesini, which are vulnerable during droughts.
It was fun meeting new people and experiencing a different side of Kenya…and the COLD beer definitely was a perk
I made it home Monday in time to load up the Land Cruiser and head back across the muddy terrain, alone, to Mekilingi. I weighed more children who were being given plumpinut and unimix. They were both improving, even over just a week. I made it home in time to take over clinic, as Vincent had to transfer a patient to Kituii for a Hemoglobin of 4 following post-partum hemorrhage 3weeks ago. However, the machine to test the blood was out of service for the past few weeks and they had just recieved a replacement. Just to put things in perspective, most people run well about 10 and the US transfuses at about 5-7. This lady was walking around with not problem. After he left, clinic was slow with runny noses and such.
Tuesday I started out at 9am in the morning to meet Kamau to weigh newborn babies out in Syokisinga, down by the river. The first two babies we had to send to the hospital, as they were both running a temperature. The third baby was super tiny, but in good health….At this point we had driven our motorcycles across some pretty intense terrain, but the road was dry. Kamau led on his motorcycle and I followed on mine (Nick and I called it the yellow bomber, as it is a VERY old SEnka and it touch and go most of the time). We made it by 1pm to Syokisinga market and looked up the hill to see black rain clouds that came out of nowhere. It flash-flood style rained for 45 minutes. After it stopped, Kamau refused to let me go home. He kept saying it was too dangerous. He said I could stay with him and go home in the morning. I convinced him I would be ok….Pole pole (slowly) We made our way over to the road we thought might be less muddy. We crossed a flowing river and up a steep, muddy, slippery hill to his home place. AFter much help from his youngest son, who was about 18, we made it to the top of the very muddy hill. We recieved help from seeral people along the way, including Mutinda, the CHW who is always smiling. I made it to Itithini by 5pm. I knew I had to get home by 630, when it gets dark. I said my goodbyes and prayed to the motorcycle angels to help me. I made it to my next obsticle: Ndioni dam…MATOPE (MUD) everywhere. Three boys popped out of nowhere and helped me, once again. I was almost home-free…two more river crossings, which I was pretty confortable with and one more large hill. Finally made it home as the sun was setting. Phew…tally for the day: 2 falls, 3hrs, and 0 injuries! Loved every stressful second of it! Dad would have been so proud of me
Yesterday was spent answering emails, doing nutrition information for a student doing analysis back home and data input into a program called epi-info.
Today I got some solid clinic time in and loved it. Saw hypertension, backpain, viral illnesses, diarrhea, superinfected chickenpox and a few abscesses. I had a little girl tell my interpreter (while I went to get her drugs) that she wanted to go home with me and then turned to her mom and said ‘you will be going home alone. I am going with her.’ These kids are so cute! I am so blessed to experience them.
I tried cowpea leaves for the first time today. They are very sweet and a bit better than sukumawiki (kale). They were a gift from one of the shop/hotel-owners I always visit. She is constantly trying to teach me to dance KiKamba style and to speak Kikamba. Her name is also Ann and she is so wonderful!
Tomorrow will be more weighing newborns in Syokisinga…I am praying that the rains with be postponed until the weekend.
Such a wonderful life out here….

Umepanda mahindi!

Neli and Jusinda playing in the matope (mud)

Ann with one of the mothers

Mutinda, showing me his Shamba, along the Athi River

Nick, Jusinda and Manu hacking up our freshly plucked chicken 'gift'

Umepanda Mahindi- you just planted corn/maize!

The shops have started to reopen, as most people are done planting and just waiting for the beautiful fruits of their labor. The bugs continue to come in sizes that get bigger and bigger. Alas! The first dung beetle of the season! I remember from my trip in March of 2010, it was hard to go a full day without seeing at least several dozen dung beetles, rolling their dung in the middle of the road. Over the past few months, I have not seen any…so I was actually a bit excited to see the little guys…so much so, I wrote a haiku to paint a small picture for you:

The rains start to fall
Insects emerge from Hiding
Dung Beetle rolls on

In case you have not seen a dung beetle in action, I suggest you take a look on youtube.com…my internet is too slow to watch the video on the link I am posting, but I am sure it is a good one!

Thursday and Friday Ann and I spent with the CHWs out in Syokisinga, by the Athi River, teaching pregnant women about infant nutrition. We had very active women asking great questions. We had a lady ask about breastfeeding while she was at work. I paused a moment, as I would normally suggest a breast pump and refrigeration of the expressed milk. However, there are no breastpumps here in Kenya. Turns out (after reading about it), you can manually express milk and keep it in a covered cup (they do not recommend bottles here, as they are difficult to clean and are breeding grounds for infection).
Prior to our education class on Friday, we got stuck in the mud…stuck in a Land Cruiser is a difficult task. It is amazing all the members of the community that pop out of the bushes to help! I don’t know where they come from, but they were all super helpful in getting us out…after an hour and a half. We showed up to the education session a bit dirty from the experience and the women all laughed and told me ‘Welcome to Kenya.’ Friday afternoon, on our way home, Nicholas decided that we needed to clean the car (to prevent rusting, etc). We visited a place called Wamuyo, where they are well-known for the male wood-carvers. I believe that it is a combination of the cost-efficiency and the laid-back/casual Kenyan approach to completing tasks, but it ended up taking over 2 hrs for 5 men to wash the car. Slightly comical.
Saturday was another outreach in Syokisinga sublocation. We had a lot more women/babies because most people are done planting. Nick and the CHWs weighed/measured over 50babies and I saw over 20mothers for DEpo shot/family planning and about 35babies for shots (I ended up injecting about 12 kiddos) and vitamin A/albendazole. It was oragnized chaos! Vincent and Justine saw several women for prenatal care. All of this within 3.5hrs!
When we arrived back on Saturday, Nick and I learned that we were being given a gift by Ann (my interpreter’s mom, Betty). She was going to bring us chicken to eat. Nick and I were pretty excited….she brought the chicken…alive…and handed it to me. I felt its heart beating and lungs breathing. She left saying,’Let me know how the meat tastes.’ Oh dear…so, with the help of Justine and her children (In her Kikuyu tribe, she is not allowed to kill a chicken without her husband present), the chicken took its last breathe. Jusinda, her 13yr old daughter, ended up completing the task without blinking an eye. Of course, I could not watch…so I start boiling water in the kitchen so we could remove the feathers. Justine gave us instructions and we made our way through plucking, removing insides and roasting/frying and boiling the chicken into a soup. Nick and I took a few small pieces and gave the rest to Justine, as she had helped us so much and she has growing children in the house. A few moments later, she came back in our house, put the gizzard on Nick’s plate and told us that it is the man’s part of the chicken. She then put the liver on my plate and, after I finished eating it, told me it was for increasing fertility. Ha ha! Oh my!

As for next week, I will be helping the CHWs teach the nutrition class and will be compiling some nutrition data from my last visit. Hopefully I will get some time in clinic..I sure do miss it!

Be blessed!

Maji ni Maisha

This is posted at one of the much-needed bore holes in Syokisinga Sublocation...along with a sign for a donkey clinic and dental outreach clinic

Ann, Nick and Me on our way home from the Friday's outreach in Mekilingi

Maji ni Maisha- Water is Life!
It has been raining like crazy here and has been turning from a dead, winter-like brown to a beautiful, tropical green. The noises that I fall asleep to are like nature’s orchestra- the frog, the chirping bats, the crickets, and the other larger-than-they-should be bugs. Even the dogs and brids are more playful. It is amazing what a little bit of water can do for an environment. I was walking through a shamba (farm) yesterday and it has only been a week or two since everyone has planed, but the maize is already popping up!
Last Friday, Nurse Vincent, Nick and myself went to conduct an outreach clinic that includes malnutrition screening, childhood immunizations and family planning (mostly Depo-provera shot). Vincent left to pick up the nurses from Katangi Hospital and Nick and I were left to set up and start the outreach with the help of Ann, our interpreter, and the CHWs, who graciously volunteer thier time. Vincent said I should man the family planning and immunization station, so I did…very nervously at first ( I HATE giving shots and making kids cry!). I gave a few Depo-provera shots and handed Albendazole (deworming) medication out like candy. Then I started getting kids needing measles and Hib (a combination vaccine for several diseases), which made me sad. The kids are so trusting and smile at you like the two of you are friends…then, all of a sudden, they realize you are sticking a needle into their arm or leg…that look in their eyes is too much- like you stabbed them in the back. Ugh! I hate that. But Vincent kindly reminded me that a little pain now is worth saving thier lives later. I think healthcare providers, like Vincent, who are born and raised in these sorts of areas have a really great perspective on life. Listening to Vincent talk about healthcare here is heartbreaking. He has these poems that he has written about Africa and they are so moving: one is called Miss African and it is about the starvation and malnutrtion that occurs here.
This weekend Nick and I went to MAchakos again- the trip was less eventful as the matatu did not break and we did not have to walk to the main road! We watched a few soccer matches at a bar and hit up the grocery store for supplies for Mac and Cheese (they actually have the most amazing cheddar cheese here). We crashed at a really nice ‘hotel’ there that ended up being $10 per night and was rated 4stars (not sure who rated them, but it was actually a very nice place to park for the night). We returned to Kisesini Sunday and did laundry and worked on our baskets.
Monday brought meetings…Kenyan meetings…that should take 1 hour, but end up lasting for 3. We met with the Community Health Worker Leaders to review all the data that we collected on the under 5 mortality and discussed possible improvements on the project. I then meet with the Traditional Birth Attendants to discuss having them call me to gether birth weights on all babies born in the Kyua Sublocation until February. I can’t wait to learn how they do home deliveries, as one of the said she can’t wait to teach me
Tuesday, Wednesday and Thursday have been spent teaching pregnant women about infant nutrition. We are really pushing women to breastfeed ONLY until 6months, which is difficult when your livelyhood is planting and farming (it is hard to take a break to breastfeed). We are also discussing introductory feeding with a balanced diet (most moms only feed smashed potatoes or bananas until 9months). It has been really great seeing women get involved and ask questions.

On occassion, I am reminded by situations of cultural differences that exist. For example, on our way back from Syokisinga yesterday, I saw a turtle in the road on its back. My instinct was to tell Nicholas to pull over so I could turn it back over. Both Nicholas and Ann yelled, ‘No!’ And I was like,’But the turtle will die if we leave it!’ They explained to me the in two days one turtle can destroy half of a shamba (farm) and ruin the families food source. Weird that I felt BAD that I was going to save the turtle…needless to say, I left the turtle where it was.

Yesterday was also Vincent’s birthday and we celebrated with goat meat, cupcakes and Kenyan-style stirfry/egg fried rice. I learned that a tradition on someones birthday is to dump water on the person…on their ‘bath’ day (the way they pronounce it, it sounds like bathday…) So everyone on their ‘bath’day gets a bath. We soaked Vincent pretty good after he finished at clinic.

I apologize for the sparce, brief posts. We have been pretty busy lately and the solar power/computer power is limited from the rain.
Athi Mua- Be blessed (in KiKamba)