Party Day and Farewells

September 23, 2012

After the last day of work, we always have a party with all of the volunteers.  This gives us a chance to thank the Kenyan volunteers and recognize their effort, spend fun time together, and say farewell.

 The party wasn't until 2:00, so we had a leisurely morning.  A few local villagers showed up to be seen for pains, coughs, wounds, and other issues.  Ever since we held the clinic in Sabaki, we have had a slow stream of people coming in the morning and evening.  With only a few days remaining and a good supply of toys left, we try to give the children a treat in addition to seeing to their medical needs.  It was punch ball day at the Sabaki Clinic today.

Punch balls were given to all child patients today

Diane and I had intended to go for a walk to the river, but we never quite made it.  While Marlene went to Malindi to pick up the pastries for the party and to change some dollars into shillings to give to the volunteers as a thank you, the rest of us worked on preparations at the hotel.  We sorted the last of the supplies, separating items to leave at the regional hospital and supplies for the wound care kits we gave to each of the volunteers. We emptied bins that we raffled off to lucky Kenyan volunteers and set aside a basket of health care kits for everyone. We also set out and organized prizes from America for the volunteers - clothing, jewelry, cosmetics and odds and ends that we were leaving behind. 

A basket of health care kits for the volunteers

At 2:00, the volunteers arrived and assembled under the gazebo.  After a welcome from Rodgers as our host, everyone was given the chance to speak to the group.  There were many heartfelt expressions of gratitude and camaraderie, with good wishes given between the Americans and Kenyans.

The speaking part of the program culminated in a speech by Francis in which he thanked the American volunteers and organization for their care and support of the people in the villages.  "Imani" means faith in Swahili, and Francis said that faith in each other is a guiding principle of the Imani Project in Kenya.  He has faith that together we can create opportunities for improving the conditions of his people.  He then praised the Kenyan volunteers for working without asking to be paid.  That teaching and caring for their neighbors was not a job, but an act of love from the heart, and he was proud to have so many people willing to give their time to lift up those who need help.

Francis praises the volunteers for giving their time to help others

Then each volunteer was given a wound care kit so that they had supplies to help treat people in their villages with burns or cuts.  Many of the volunteers have become unofficial health care workers in their communities, and their neighbors come to them for help.  Names were drawn to give away the empty bins, which are highly valued since plastic storage bins are not available in Kenya.  Refreshments of cake and pop were served while people came one-by-one to choose prizes from the clothing and jewelry.  Henry took charge of the iPod and Boombox speaker to select music for the festivities.

 

The volunteers get their wound care kits

The party ended with a group photo of all of the volunteers together.

Imani Project volunteers, 2012

After the Kenyans all departed, the Americans made a final trek to Hippo Camp on the river.  No hippos were out, but we had a beautiful sunset to end the day. 

Sunset over the Sabaki River

 

HIV/AIDS Support Group

September 22, 2012

The last two weeks have gone by quickly, and things are winding down. For five days, we have had clinics every day, with Wednesday being a half-day in Sabaki.  We are looking forward to an opportunity to go into Malindi, to do a little shopping and find the holy grail of comfort in Africa -- a cold drink.

This morning was the HIV/AIDS support group meeting.  Marlene assured us it would be finished by noon, and it was finished by noon African time: about 1:30.  While Marlene, Earline, Cindy, and I went to Musifini for the meeting, Diane stayed back to sort through supplies to create twenty wound care kits that we can leave with the Imani Project volunteers to continue wound and jigger care in our absence.  After two weeks of intensive clinic experience, the volunteers are actually better qualified and trained than the community health workers (CHW), even though CHWs have to complete training in Malindi to be certified.

Two years ago, the HIV/AIDS support group was chaotic and poorly attended, but not this year.  34 people, mostly women, showed up at a church in Musifini. 

HIV/AIDS support group meeting in Musifini

People from different villages traveled some distance to be there, including a few people from Sosoni who were newly diagnosed due to AIDS tests we administered at the clinic. We also tested three people this morning, and two of them were positive. 

2 positive tests

Marlene stated the purpose of the group very well when she told the attendees they are proof that people with the HIV virus can and do live healthy lives if they take care of themselves. Working together to support each other helps them all to learn what they need to know and keep doing what they need to do.

Francis then gave what Marlene called a "fire and brimstone" speech. There seemed to be two main themes (of what was translated for us, at least). The first was to always use condoms to protect themselves and others. Since men are not always responsible enough to supply the condom, the women should be prepared with their own supply. The second theme was that nothing will remove the virus from their blood and not to waste money paying for "healing" from traveling preachers. Apparently, it is common for preachers to come to the villages and make a show of laying on hands and shouting a prayer that will cure their HIV/AIDS infection…for a fee. The more the people pay, the more powerful the healing is supposed to be. Francis told them that when they give their money to the preacher,  all that happens is that their family goes to bed hungry and the preacher gets fatter.  Only when Jesus himself comes down to give the blessing, he said, could you be healed.

 

Francis works the crowd with his "fire and brimstone" speech

The Imani Project gives a lot of support to these people. Each person who attended got a health kit that Earline put together, six kilo bags of unga (corn flour), three bottles of WaterGuard (chlorine water purification liquid), and about two dozen condoms.

Earline explains the health kit

Handing out condoms

Everyone got so much, we wondered how they were going to carry it home. We distributed what boxes and flour bags we had, but the rest had to make do. 

 

After the meeting was over, everyone was served bread and hot tea.  They only had seven or eight cups, so they served a few people, washed the cups, and then served some more.

Hot tea and bread

Marlene hoped that word would spread of how much everyone received so that others with HIV/AIDS would want to come and join the group.

Carrying their goodies in a conga on their heads

On the van ride home, we finally had a chance to stop at a little valley with four big Baobab trees that I've wanted to photograph. We drove past it every day on our way to and from the clinics, but with a van full of people after a day or working, I couldn't ask everyone to wait while I took photos.   Cindy and Earline I could ask to wait, however.

Since I was riding in the front seat, I had a chance to chat with James, the van driver. While going through Sabaki, he pointed out a local witch doctor and the Baobab tree where he treats people.  We asked Rodgers later about it, and he said it is devil worship.  The witch doctor lives and works at a Baobab tree because those trees are considered sacred places.

The witch doctor's Baobab tree, surrounded by bushes

They call on the spirits of the ancestors to intervene in people's affairs, and use herbal "remedies" in their spells and for more conventional herbal healing. One example that Rodgers gave is when a woman in Malindi meets a visiting mzungu (white) man and wants to bring him back or keep him as a husband, she comes to the witch doctor in Sabaki. He washes her with a special herbal mixture and call on spirits to answer her desire. She pays him a fee then, perhaps 5000 shillings (about $6.50), but if she gets her man, she pays him another fee later, perhaps 20,000 shillings.  Apparently sorcery for hire is alive and well in Kenya.

We did make it into Malindi in time for a late lunch at I Love Pizza before shopping. Since Malindi gets a lot of Italian tourists, the Italian food is pretty good. We were surprised to see that the restaurant had a pizza delivery tuk-tuk, but I don't think they would deliver to Sabaki.

I Love Pizza delivery tuk- tuk

Then it was off to the tourist market!

Malindi Tourist Market

 

Looking for bargains

 

The shoppers

Sosoni Clinic, Day 2

September 22, 2012

Today was the last day of clinics.  Our work here is now over, except for an HIV/AIDS support group meeting tomorrow.  It's kind of odd, but kind of a relief at the same time.  It has been good to be here and to serve these people, but at the same time, it is pretty far outside of the comfort zone of our Western life, so there is a certain amount of "bucking up" we do to venture out into this wider world.  Sometimes I stop and think to myself, "I am standing in Africa," and I picture a map of the world and realize how far away I am from my normal life.

In one way, everything here has become normal.  The life we see of people in the villages, the mud huts and dirt floors, women walking and carrying everything imaginable on their heads is what you see all around.  It isn't like there are two worlds side by side (at least not that we see).  We don't travel to all part of Malindi, but the buildings leading into the city and the roads and stores all have a common aspect to life in the villages.  The walkway in the tourist market is mostly broken concrete and rubble, for example.  The hotel here is very comfortable for the standards of Africa, but still primitive by Western standards.  At least for me, I leave my expectations of Western standards behind and adapt to the surroundings that are here. 

In another way, it can never be "normal" and recognition of the poverty is continuous.  In the clinics, we also see children wearing rags for clothes, with shirts barely holding together. Whenever we hand out anything, there is a huge surge of people wanting to get whatever it is, because they have nothing.  Children don’t seem to be starving, but they have subsistence levels of food, no toys, and inadequate health care.  Many people have rotten teeth and toothaches because they have no dental hygiene.  They don’t have enough money to travel 10 miles to Malindi to see a doctor, and they can't afford the medicine if they do get diagnosed.  Several of the Kenyan volunteers are unable to pay for school tuition.  What they are lacking is anywhere from 8000 shillings ($100) for high school fees to 50,000 shillings ($700) for a post-secondary certificate program to help them be employable. An amount that is not a great sacrifice for Americans can change a life here.  How little it would take to improve the quality of life here.

For our final clinic day, I think everyone was tired and ready to come to the end.  Patience seemed a little short at time.  The number of patients seen today was double other days.  Although Amy and Anya were gone, we had three Kenyan health workers with us.  They moved through patients at lightning speed, for several reasons: they didn't have a translation delay, but they also did next to nothing to evaluate the patients beyond the patients' own statements. They didn't listen to lungs or heart, look in ears or throats, etc.  Their treatment was to hand out medicine that seemed to correspond to what the patient said was bothering them.  So medication was flying off the shelf and patients were flying out the door.  For the first time in either trip, triage was falling behind treating the patients.

Towards the end of the clinic, I was grateful to be called away from triaging to photograph the Imani Project volunteers handing out a bag of flour to each child.

 

 

After the distribution of the flour, I skipped out on doing more triage (since Mr. Baya was handing it :-), and I took a walk through Sosoni to photograph the sign for the primary school that was out on the main road.

Sosoni Primary School sign on the road through Sosoni

It was about a half mile out to the road, and I got to see some of the houses in the village in more detail than is possible from the window of the van as we drive along.  Everything is very humble

Buildings in the Village of Sosoni. The white colored wall is smoothed mud that is whitewashed.

Houses in the Village of Sosoni

 

The "toilet" behind someone's house - a sandy and rocky patch with walls for privacy for "short calls" (urination)

While walking through down the road, three people sitting in the shade called our "Welcome!", so went over.  They offered me a seat, and we chatted for a few minutes.  Their English was very good, and they asked if I came from America and where in America.  I told them "Washington" and they said, "Oh, Washington, D.C.!" (as everyone does). I explained about Washington state.  Then they asked about Obama and how he's doing in the election (as everyone does).  I said it was hard to predict.  The woman said everyone in Kenya is praying for Obama.  We talked about the Kenyan presidential election in March.  They thanked me for coming to their village; Sosoni is remote and does not have easy access to medical care.  I love the Kenyan people.  Everyone is friendly and welcoming; it is hard to imagine a more gracious people!

 

My New Kenyan Friends - Kitsao, Julius and Mapenzi

The ride back was almost our last van ride!  We have two more tomorrow to go to the HIV/AIDS support group.  I can't say I'll miss that daily experience any, although I do enjoy watching the countryside from the windows.  If only we could stop and take pictures!  Taking photos from the moving van is not good, but not entirely without success.

Baobob tree, as seen en route



Sosoni Clinic, Day 1

September 20, 2012

All of our travels to clinics is done by van.  I don't think the van has had working shock absorbers or struts in ten years, so travelling on the dirt roads that connect the villages is a long, rough ride:

The van

 The road to Sosoni today had a few ruts.  I love the red dirt, though!

 

The road to Sosoni

 

African Time really hit us hard this morning for the Sosoni Clinic.  African Time is like "island time" in Hawaii; everything runs late and everyone is waiting.  The van arrived, but then we were delayed while Marlene tried to straighten out a problem with email from the Malindi Rotary Club about a well drilling project in the villages.  We finally got on the road and stopped at Musifini to pick up the Kenyan volunteers.  We sat there for a long time, and eventually learned that the van needed oil which was taking a long time for some reason.  We'd been told that the drive to Sosoni was about 15 minutes from Musifini, but we didn't arrive until about 40 minutes after leaving Musifini.  Then we waited while the arrangements were completed for which classrooms at the Sosoni Primary School we would use.  No one seemed to know what we were waiting for much of the time. 

While waiting we took advantage of prime photo opportunities:

Phil and Diane at Sosoni Primary School

American volunteers with Jackson, Helen, and a bunch of Kenyan children at Sosoni

We eventually got set up and got the classes started. 

I hadn't planned to take photos today since I have taken so many on other days, but I loaded up my telephoto lens. That allowed me to get "stealth" close-ups, because I was so far away from people, they didn't realize I was taking their picture.  I have not been able to use my 24-105mm lens (my primary and favorite lens) because something has gone wrong in the electronics, and the camera gives me an error most of the time when I try to use it.  Major bummer!  So my choices are wide angle (17-40) or telephoto (70-300).  I've been using the wide angle since I am usually close to the people I am shooting, but today I played with the telephoto.  I got some good portraits, like these:

 

 

 

 

It's very common for people to not smile when you take their picture. If you show them the first picture, though, they break into a smile for the second one:

No smile for the first photo

 

Smile after seeing the first photo

Diane had an interesting experience in the clinic today.  After getting medicine for one woman, she looked down and started talking.  She got up and walked away.  Jackson explained that she was a devout Christian, and she had just said a prayer as a thank you for the service rendered to her.  Diane sent Jackson to find her and give her a picture of Christ holding an African child.

 

The devout woman who said a prayer as thank you

Kadzifitseni Clinic

September 17-18, 2012

The last two days we have been holding clinic in the village of Kadzifitseni  (pronounced cod-zif-fits-enny) which translates to "go and hide" in English. The village is immediately next to the village of Pumwani (pronounced poom-wah-nee), which translates to "relax".  I'm guessing that people on the run would come to Kadzifitseni to hide and when they successfully escaped their pursuers, they stayed and hung out in Pumwani to relax.

Kadzifitseni Primary School

Our start at Kadzifitseni continued a string of forgetfulness that is plaguing us.  For three days in a row, we have travelled somewhere and forgotten something important at the hotel. On orphan day, a suitcase full of gifts was left under a bed, which took 45 minutes round trip to retrieve. On Sunday, Earline and Amy forgot to take a bag of medical supplies to visit Kitsao, a paraplegic orphan Earline sponsors, which took 90 minutes round trip to retrieve.  At Kadzifitseni we forgot a bin with medicines and supplies, which took a two hour round trip to retrieve.  Our dementia is costing us a lot of time.

Fortunately, we had two hours before the clinic started, as we set up and then taught the health kit classes and an AIDS class. We split into four groups again, with Cindy, Anya, Amy, and Earline teaching a class while I played photographer. It is interesting to see the difference from one village to the next.  While people at Karimboni were very attentive and engaged in the instruction, the Kadzifitseni crowd was pretty stoic and seemingly unimpressed.  Even when we took photos and tried to get them to smile, most just stared at the camera.  But their eagerness to get the health kit bags shows that they appreciate having them!

 

 Earline teaching a Health Kit class
 

 

Women who received their Health Kit bags

The medical complaints also are quite different here versus Karimboni.  Karimboni seemed to be dominated by eliphantitis and swollen testicles.  Although we are only a few kilometers from Karimboni, we had only a few reports of the parasitic swelling so common in Karimboni.  On day 1 at Kadzifitseni, the theme of the day was chest pains and "pains around the waist".  Day 2 was dominated by toothaches.  Diane reported that in several cases she had, there was a really rotten tooth that needed to be pulled.  On day 1, many people were anemic and needed iron.  Diane prepared a few iron doses for day 2, and then had no anemia at all. 

Some of the villagers don't have a good sense of what is relevant to their complaint.  The first woman I spoke to on day 2 told us that she fell down while carrying firewood on her head, and it landed on top of her.  Now she has chest pains…10 years after falling down.  The next lady said she fell out of a tree and was stuck in the chest by a large branch.  Now she has chest pains…17 years after falling out of the tree.

Some people have very serious problems, though.  We had several people with jiggers -- sand fleas that burrow into the foot, lay eggs, and then burrow out when they reach the larval stage.  This is a serious problem in many parts of Africa.  Earline and Anya worked for over an hour to get out the worms and then dress the wounds.

 

A girl with many jigger wounds

 

Earline applying gentin violet, an antiseptic

 

Lots of people wanted to be seen, more than we could possibly see, of course.  This trip we have a better story to tell when we have to stop seeing people.  The medicines that the Imani Project has purchased are left with the community health workers, so the villagers will still be seen and get their medicine.

 

People waiting to be seen at the clinic

 

Kenyans do not use family names in the same way that westerners do.  The second name is a tribal name, and so can be many different names.  It is common for children in the same family to have different tribal names.  That would make doing family history work a challenge! Henry has been telling me the translation of the people's names as they come through.  Amani is a common name; it means "amen".  We had two named Furaha, which means "happiness".  Baraka means "blessings" and Zawadi means "gift".  Some other names are a little stranger, such as Changawa, which means "At least".  Kaingu means "a small cloud".  And then there are names that make you wonder why parents choose them.  Baya is a common name, but it means "bad".  One woman was named "Mashaka", which means "problems".  One girl had a last name of Mzungu which is the word for "white person".  "White Person" would be a tough name for an African to have in middle school.

At each village, the Imani Project gives out corn flour to the children, but we have never seen this happen because we are always busy with the clinics in the afternoon.  This time, Francis sent someone to fetch me so I could take pictures.  When I arrived, a large group of children were sitting under a tree, and Francis had them say thank you to the Imani Project in unison (Asante, asante, asante, asante sana!" which is "thank you, thank you, thank you, thank you very much!")  I got a video of them and photos.

 

Children with their corn flour

 

Children with their corn flour 

 

Anya and Earline work on wounds and burns

 

A stooped old man at the clinic

 

The American volunteers after the clinic