Research

Haven't been blogging lately because nothing has been happening that is blog-worthy. I can talk a little bit about my research though! **Disclaimer: Not much detail here because the paranoid academic in me says not to since I may make this topic my dissertation.**

Yesterday Leslie and I had a meeting with Nicholas, the Lea Toto Program Manager. He wanted an update on our research and how we were finding our time at Lea Toto. This meeting actually got me very excited for the work that I want to do. Up to this point I have felt like I was just floating around Kangemi aimlessly. I was told to shadow the social workers but they are usually in their office, which has no room for me. Actually, there was no place for me to sit so many times I would just awkwardly stand in doorways. If you know me at all, then you know that I need direction in my life. I always have a plan and when I don't have a plan I do not function very well. Even if the plan is minute or careless, a plan is still a plan. Staying for the past 3.5 weeks at Kangemi have been great and priceless. I have learned so much about the people and the program by being there. I would not replace this for anything. That being said, I do have to admit that I do not enjoy aimless wandering. I want/need/have to have a purpose.

I have found that purpose. It takes the form of a research question and may possibly morph into my dissertation one day. But that day is a very long way off. First I have to write my thesis, survive prelims, get into Rollins MPH program, complete MPH, and then I'll finally devote 2-3 years to my dissertation. The trick is to decide on a dissertation topic early enough that you can begin writing sections of it for other classes. I also need to decide if I love this topic enough to spend the next 5 years of my life on it. I think I might.

My time at Kangemi is counting down. Only 3 more weeks and 2 of those I will be traveling around to the other Lea Toto centers. In our meeting we decided that it would benefit Leslie and I the most to get the opinions of other centers and not just our own. We will be traveling to Kawangware, Kibera, Dagoretti, Kangemi, Mukuru, Zimmerman, Dandora, and Kariobangi. We will spend a day at each center interviewing staff and learning about the work routine there. I'm excited to see the other informal settlements around Nairobi.

Forgot to mention this! Several of us went to church on Sunday in Kibera. It was very exciting to visit Kibera. I did not realize how close we live to the entrance- only a 15 minute walk. I was deeply impressed that Kibera had several paved roads. I've been told that since Kibera is known around the world that they get a lot of foreign aid, more than others in Nairobi. Also, there are many, many, many foreign aid workers there that conditions have risen a bit. We were invited to church by one of our St. Paul's colleagues. She is a minister in a couple churches around the area and grew up in Kibera. The service was all in Swahili but you don't really need words to hum along to a hymn. During the service I just looked around and observed the other people. There were only about 10 other people at the service and several children. One child kept trying to sit in our laps and screaming, "Hi, how are you?" It was great fun.

Until next time!

Hell's Gate Gorge

We went to Hell's Gate National Park on Sunday. Our plan was to go on Saturday but it was raining all day. This is a sign of the impending apocalypse because it is not supposed to rain in Kenya unless it is the rainy season, which ended a couple months ago. Anyways, we decided to wait another day because it would not be as fun in the rain and potentially life threatening. Hell's Gate Gorge is known for its deadly flash floods. Not sure how many people die each year, but it's substantial. Spoiler alert- we all survived our trek.

In all the guide books they say that the trip into Hell's Gate Gorge is a bit of a hike and troublesome for the weary traveller. I'm calling bullshit on that right now. Hell's Gate Gorge is part rigorous hike and part terrifying rock climb. I've never been rock climbing... until Sunday. Crash course in a gorge is the best way to learn. We met with another student from Emory last week and she told us a little bit about her experience trekking through the gorge. She said that she did not go all the way to the end because of the crazy acrobatics along the way. I'd like to say that we all survived the entire way. Very proud of myself.

I should have known the level of difficulty within about 2 minutes of starting the trek. Our first obstacle was actually getting down into the gorge. We had to pick our way down a pretty steep cliff and then swing ourselves from a tree branch onto a small (half the width of my foot) outcropping of rock. Then just jump a rushing river and up the other side! Whew, one down. Many, many to go.

I want to express my sincere and overwhelming gratitude to our guide. He was amazing. If you looked through my pictures on Facebook you will see one where I caught him in action. He literally just got a running start at most of the rocks and leapt up on top of them. He was like a mountain goat. Many times he would wedge his foot against yours just in case your foot/shoe gave out and started to slide down the rock face. At one point he swung Katie Sack by her arms to set her down across a stream. It was hilarious. I think I caught the aftermath of that one on camera too.

Also, captured by Leslie, is the look of absolute terror on my face during an especially "fun" obstacle. We had to drop about 5 feet to the ground but missing the water. That is the one Katie was swung over. Did I also mention that it had rained? Plenty of mud and slippery rocks in the gorge, which made the trek that much more fun (aka terrifying).

I'm complaining a ton because it was hard work but worth it. It was a beautiful experience and bonding time for us. I can't say that I would do it again. Not after scraping the skin off my already poorly wounded leg. I got pictures of that too. I would also need to work on my fear of heights. And work out at the gym non-stop to feel even remotely in shape for that journey again. Still have plenty of crazy stories, ask me about them sometime and I will try my best to act them out.

I got some amazing pictures though. Nature at its finest.

Sidenote- some drama here at the apartment. Emily and Whitney went to Nakumatt this evening for some groceries. This is about 7 at night and dark, which also means that the street in front of our apartment complex is busy. They were crossing that street when a motorcycle came out of nowhere and hit Whitney. She fell to the ground and badly scraped up her feet. The motorcyclist also fell off his bike, so that makes us feel a little bit better about the whole thing. He was trying to beat traffic and take the unofficial "middle lane." Poor Whitney, it messed up her feet so much and she was in a lot of pain. She and Emily went to a clinic to make sure that nothing was broken. Hopefully she is just bruised and will be just fine.

Also, Katie Sack has never had ice cream cake and that is a travesty.

Done for now. Until next time!

Babies!

I got to work today and saw that there were two women and a small child sitting outside the clinic. This was odd because the clinic is closed this week. I figured that they had an appointment with a social worker. While sitting and having tea I heard the child cough a couple of times and it sounded like she had TB or some crazy, awful chronic cold. Beth told me that Faith would be taking the car and going to Nyumbani in Karen. This is the respite home where the social workers, doctors, nutritionist, or any of the combination can recommend that a child go. This can be reasons of severe malnutrition, bad home life, or parents not adhereing to the child's medical needs.

After about an hour we all pile in the car, four to the backseat again, which is super fun. Played with the baby a little bit on the 30 minute ride to Nyumbani in Karen. Sidenote- Karen is the nice/expensive suburb of Nairobi. There is no slum/informal settlement there, only the children's home that is run by Catholic nuns. When we get through the gates my first thought is, "Wow, this is an oasis." And it was. There was a gorgeous fountain and paintings on the walls of the buildings. All the buildings were really nice and clean, which is hard because dirt in Kenya goes anywhere and everywhere. The children were at recess when we got there so I saw them playing on the playground and on the football field. It was great to see them so happy and healthy.

We went straight to the intake center where some babies were and where they take measurements of the new children. In the room there were two cribs with babies in them and 3 other babies in small plastic chairs. These babies ranged from 1-2.5 years old and were the best mannered children I have ever met. They just sat in their small chairs and watched the adults talking. The babies in the cribs were smaller than the others and probably could not hold themselves up. One of the babies was smaller and just the happiest child ever. He was playing with his toys the whole time and making cute baby noises. The other baby was the complete opposite. For the first thirty minutes he just sat there staring at the blanket. Not moving, just staring. It was heartbreaking to look at him. After awhile I went over to him and tried to engage him in playing with a couple of the toys in his crib. Didn't really work that well. I got a couple of smiles out of him but not much. Then he started making small noises that I knew were about to turn into crying. I asked one of the nurses if it was okay to pick him up, which she said yes.

As soon as I picked him up he stopped making those horribly depressing noises. He saw the sun outside the window and grabbed hold of the windowsill. I leaned up against it so that he could look outside easier. I made a joke that we were making our escape, just really slowly. He still hadn't really smiled or even looked at me up to this point. What could I do? Other than make a fool of myself, complete with crazy noises, weird circling, bounciness, and playing peek-a-boo with my shoulder. Guess what? He smiled!!! It was amazing.

I kept on with this for about 30 minutes just enjoying watching him smile and stare at me like I was the craziest person on the planet, which could be true. I shared some secrets of the universe with him. I told him to listen to the nuns and not get into any trouble when he left the center. I told him not to chase after girls but instead focus on school. My wish for him was to go to college and then become a doctor. I wanted him to help the world that born him into such bad circumstances. I whispered that being HIV positive was not the end of the world, and that many people around the world live such normal lives with HIV. I wished for him to grow up and help fight the virus inside of him. Be a good man. Be a great man.

Not sure if he listened to me, but I like to think that he did.

After awhile he started getting sleepy. He ended up falling asleep in my arms with one hand on my neck. It is amazing to watch a baby fall asleep. One of the wonders of the world. They try so hard to keep their eyes open and watch you, but just can't help it.

After about 20 more minutes of watching this angel sleep I realized that we were leaving. I was so sad to put him down and leave him. I slowly put him back in his crib and silently prayed that he would make it in life.

Been Awhile

Haven't really updated the blog for about a week now. Sorry! Not much going on lately, at least not good enough to really talk about. I was told last Thursday that it may be a good idea to take a couple of days off so that my leg could heal. I took last Friday and Monday off so that it could scab over properly. Now when I walk it doesn't open up again. The small victories in life, my friends. I still get looks and questions about what happened. Fighting off a lion is a much better story than falling down a cliff/hill/mountain.

Work is pretty slow this week because the medical clinic is closed so the personnel can attend training in Kawangware. The social workers still have home visits to do this week, so that keeps me busy. I went on a home visit with Paul the intern and a CHW. We went to one home that had about 4 dogs outside. Thankfully they did not attack us, just sniffed for awhile. We went inside the home and I got to play with a baby for about 20 minutes. She was absolutely adorable. She kept looking at my hand like I was an alien, which to her eyes I probably was. When we left it really hit me that she was our client. Meaning that she is HIV positive. I still don't know how to deal with these realizations.

I was heroic on our home visit on Monday. We were walking down a ravine/sewer runoff and passed a chicken with some baby chicks. One of the babies' foot was caught in a piece of grass. I could not help it. I reached down and freed the little guy. As soon as I bent down near the baby the mama chicken started to run at me. Thank goodness I was able to free the baby quickly enough to escape the mama. Paul and the CHW looked at me like I was crazy for helping out the little guy. Circle of life. But I believe in karma.

To pass the time at work this week I have started doing the crossword in the daily paper. Getting pretty good at it. There is another one that is called "codeword." It looks like a crossword but they give you 1-2 letters, then you have to fill in the rest of it. No hints or help at all. Just the letters given. Some of them are super difficult. Leslie also does it so we text back and forth at work to see if we are on the same track. Not so much usually.

We met with our future safari guide, TImmy, earlier today. He lives in Naivasha where Hell's Gate and the lake are. It is about 1-1.5 hours northwest of Nairobi. We have decided to make a trip up to Hell's Gate this Saturday for some hiking. We talked with Timmy about planning our 3 day safari in the middle of July. Super excited and he does it pretty reasonably priced. He was a character though. He was the guide that took the Emory group last year and comes highly recommended. I can see why- he is very enthusiastic about what he does and just wants everyone to have the best time they can. I'm excited to see the Maasai Mara in July with the great migration.

Full disclosure- Emily, Leslie, I were sitting in the coffee shop waiting for Timmy when this conversation happened:
*Leslie drinking a Stoney, which is made by Coca-Cola*
Me: "Wow, they make a ton of stuff we don't even know about in the states."
Emily: "You would if you visited The World of Coke in Atlanta."
Me: "It's so expensive. Parking is crazy. I would just take a matatu... wait."
*Crazy laughter ensues*

I am fully embracing the Kenyan culture, I am very happy to say.

Rural vs. Urban

Sorry, I've lost track of the past couple of days. Craziness back home with my sublet and craziness at work.

Yesterday I went with Faith (social worker) and 3 community health workers to Limuru to visit some clients. Limuru is about 20 minutes from Kangemi, but is still the closest Lea Toto Program to them. Most ride several matatus to come get medicine and the social workers take a whole day to visit them. We spent a total of 6 hours going from door to door checking on our clients. Most were not next to each other so we had to pile in the truck to a different home or walk a long way.

Let me just say that the truck was packed. Get this picture in your head- the driver, a upper middle-aged man in the front seat, then me and 3 other grown women in the back. We were literally on top of each other. The road was so bad that the best thing to do was make yourself jelly and just go with the bumps. At one point the bump was so bad that the woman sitting "next" to me landed in my lap. Not the best transportation for 6 hours, let me tell you.

There is a major difference between living in a informal settlement in Nairobi and living outside of the city. Most rural families do not go hungry because they at least have room for a garden that they can subsist off of. Most homes we visited were much bigger and had more furniture. Some even had a cow or two. Going further some were in compound-like facilities.

We met one woman who was clearly the matriarch of the family. She had the roughest hands I have ever felt/seen. The whole time Faith was speaking to her all I could think about was her story. She was older, probably around 75-80, and walked with the help of a sturdy walking stick. I cannot imagine what she has been through in her life or the years of hard, labor intensive work she has endured.

I normally ride with Leslie on the matatu in the morning because we both have to go to Kawangware. At the stop we usually split ways: Leslie walking 100 yards to work and I begin my 45 minute trek across Kawangware and through Kangemi. Going home we usually don't ride the same matatu. We both leave work at 5pm but she gets home much faster than I do. I tell you this so that you know why I catch a matatu by myself in the rush hour traffic to get home. I realized at an early age that my face is a permanent scowl unless I consciously try to turn the corners of my mouth up. I'm not mad or upset, that's just how my face is when it is relaxed. During my attempt to catch a matatu with everyone screaming at me in Swahili in rush hour traffic, I have come to fully appreciate my permanent scowl. If you do not look pleasant or like a newby, then most matatu drivers will not harass you. Very handy to know this. And when you look like you may go with another matatu, then they will open the door to the front seat :) Or if you look nice. Or are American. There are many reasons why you may sit up front. But it is really the best place to sit on a matatu.

Until next time!

Life at Lea Toto

Finally got to actually talk to my parents last night on Skype. Although they could not see me. Mom still hasn't figured out that part :) Hopefully, by next Sunday they can figure it out and will be able to see my shining face. My dad asked me to talk more about my work and my mom asked me to take some pictures.

No problem talking about my work. I have just not had very much to say since I only started last Thursday. Big problem taking pictures. I explained my apprehension to my mom last night and she completely understood. As a white woman I would not feel comfortable pulling out an expensive looking (not really) camera in the middle of Kangemi slum to take pictures as if I was in a zoo. It's just not polite and I would be afraid of any consequences to my actions.

So work at Lea Toto is interesting. Lea Toto has several clinics across Nairobi, a children's home in Karen, and the village out by Kitui. I am stationed at Kangemi, which is an informal settlement not far from where we live. In all fairness, all of the informal settlements are not that far away, except for Mukuru. Kangemi is pretty large, but not as large as Kibera, which ranks in the top 5 largest slums in the world I think. Kangemi has about 100,000 residents, according to the best sources which are not that great. It's really hard to conduct a census in a slum, or so I have heard.

Today started off pretty rough. It was announced that we lost two clients over the weekend. One we had just discussed on Friday and that the family should take him to the hospital for care. They both died of complications due to HIV/AIDS. I had a conversation on Friday with the counselor at Kangemi about the most pressing problems at Lea Toto today. He was saying that most who have HIV/AIDS are prescribed medications, but not everyone who has medication takes them. The major reason for this is stigma. Neighbors know your business and if they know that a member of the family is HIV positive then they can ostracize you and your family. Even to the point of forcing you to move.

Let me just get this out in the open- no one does anything quickly in Kenya. I always feel as if I should be doing something at work then look around and realize that everyone else is taking tea. So I pull out a book and start reading. *If the clinic is busy, then we are working.*

Last side note- I was sitting in the office and heard a baby crying. I realized that the baby was there because it was HIV positive. What a sad world it was born into.

I went on 8 home visits in three hours with Paul, the intern, and a community health worker (CHW). We got in the truck and drove for about 20 minutes to the other side of Kangemi. At one point in the "road" the truck had to stop due to the awful condition of said "road." Pretty sure that if he had kept driving we would have either 1) fallen into the ravine or 2) been stuck in the mud. We walked along the road for awhile to get to our first visit.

Side note- (I lied, this is the last one)- It takes forever to walk anywhere in Kangemi because of the roads. I am constantly wondering where I should put my foot next. God help me if I am going downhill or uphill, like my morning and evening treks.

The first home visit was off the road, up a small hill, turn left at the clothes line, right at the sleeping dog, towards the crying baby, right at the old campfire, under the wooden poles, and through the metal-sheet and bed sheet doorway. By the way, all walkways off the road are only about 1-2 feet wide and usually have some water-like substance running down them. Can you picture that? Now live there. Seems impossible, right? Well, millions of people do it their whole lives. Feel like a horrible American yet? I do.

This post might have been a downer but there was so much goodness in the day too. Walking during the home visits I played with many children. All children from about 3-5 years know how to say "Hi, how are you?" In English and that's about it. As soon as they see me they all start screaming it at me. Very cute. Also, I got a lot of apologizing from random Kenyans when they saw my leg. Everyone gave me a second look to make sure that it was not fresh blood. Then, they all said "Sorry, I'm sorry sister!" Very nice of them to apologize for what that stupid mountain did to me :)

Something else to put this day into perspective- We went to one woman's home for a visit and she graciously invited us inside. She had just gotten home and kept apologizing for the state of her home because she was not expecting company. I kept saying that it looked great and she gave me the best smile ever. This area may just be "slums" to outsiders, but to those who live there, that is their home. They work hard to pay rent and keep it nice. The absolut least I can do is respect these people.

Elephants and Giraffes

I'll get to the animal petting soon but first let me tell you the story of how I injured myself.

Every day to get to work I have to take a 10 minute matatu ride then walk for about 30-45 minutes. During this walk there are 2.5 monstrous mountains. Every morning I go down a red dirt one and then up 1.5 rocky, slip-sliding one. Every afternoon is down the 1.5 deathtrap and up the red dirt one. No big. On Friday afternoon I was going down the rocky one with three coworkers when my right foot settled on a very unstable rock. The next thing I know I am sliding down on my butt with my right leg tucked under me. Everyone immediately reaches down for me to help me back up. I say that I am really fine and that it didn't hurt that bad. Until I looked down at my right leg. Blood everywhere. My friend Rahab says, "I think there is a rock in your knee!" No way. I look down at it and think "nope, that's just my skin." On a closer inspection I realize that there is indeed a rock completely embedded in my knee. Someone says that I should just pull it out because we all think that it is a small rock and no big deal. I have it half way out when someone says "Stop! It's really big, maybe you should just keep it in there." Ummm... no way. I am not pushing it back in my knee or leaving it hanging out halfway. I continue to pull it out. As soon as it is out I realize two things. 1) it is a BIG rock. About the size of the tip of my thumb. You may say that it is not that big, but when it is in your knee that is HUGE. 2) there is blood now gushing out of the hole in my knee down my leg. One of my friends hands me about 5 baby wipes to mop up the blood and another goes back in Kangemi looking for some band-aids.

Also, remember that this is the first mountain and that I still have 30 more minutes of walking and a 10 minute matatu ride before I get anywhere near my apartment.

My friend comes back with the band-aid and I slap it on my leg. I decide not to look down at my leg again until we get to the matatu stop, because I know that if I do I will just sit down and cry. I make it back to the matatu stop with many, many strange looks at me on the way. When we stop I realize that the band-aid is hanging off my knee and there is blood running down my leg. I mop it up some more and slap another band-aid on for the ride home.

Long story short- I get home and have been nursing it to health. I do not want an infection from that bloody rock. I have been lathering it in neosporin and dousing it in hydrogen peroxide twice a day. So now you know why I have been limping around and look ridiculous climbing the 5 flights of stairs to our apartment every day. If you were wondering that is.

On to baby elephants and giraffes! By now you have probably seen the 150 photos on my Facebook of the baby elephants and giraffes we saw yesterday. So amazing!

We went into Nairobi with some other Emory students that are here for CDC research to the Nairobi wildlife place. Not sure of the name right now, but I took a picture of the sign if you want details. Only 500 KSH to see the elephants (around $5), which was a donation to help them along. They house 23 baby elephants from the wild and when they are ready, release them back. Most of them are in the orphanage because their mothers were killed by poachers and park rangers found them all alone. The park rangers are their family so they play with them everyday and feed them every three hours, which means that every baby elephant sleeps in a pen with a caretaker each night. How amazing is that? Anyways, you can see the photos and I will attempt to upload more videos when the internet is better.

After the baby elephants we went across the park to the giraffes. Amazing! As you can tell from my photos they have no fear of humans. I even kissed one! On the cheek :) Leslie caught a picture of it so I will have to look for it on her computer to post to Facebook. It was very cool. There was a great gift shop there where I bought some really cool stuff.

I will confess that I have done two American things this weekend. 1) I had KFC yesterday. It was so good! Not sure if it was good because it was American or if it was just because it was good food. Probably a mixture of both. But they did not have mac'n cheese which was upsetting. I have also caught myself saying chips, instead of fries and petrol, instead of gas. Changes. 2) I just got back from the movies. There is a cinema in the mall that we live by and if you know me at all, then you know that I adore movies! It was so cheap, only 550 KSH (about $6). I guess that isn't that cheap but compared to Atlanta it really is.

That's all for now. I'm about to head downtown to meet one of Leslie's coworkers for some amazing views and sightseeing. And we will also buy our train tickets to Mombasa for August :)

Stay tuned!