Thursday, October 30, 2008

This week...

This week has been a definite learning experience...

Do you know why organizations don't do surveys, don't do measurement and evaluation??BECAUSE IT TAKES SO MUCH TIME! and it's SOOOO difficult to get the Right message across. 

This week we developed a survey, we had questions about the general demographic of the families, health, water, sanitation, and agriculture. We created this 4 page survey, that even in English had some confusing bits, and then we trained our Community Development Committee. 

We trained them how to give the survey, what to be careful of, what questions would be confusing - how to ask them in a couple ways to get to the right answer, etc. And then, today they CDC was to train the Chairmen of each of the Nuru Groups. Well...I must say that throughout the entire time, I was thinking -- oh my gosh, this is ridiculous. 

Now, let me explain - it's not ridiculous to ask people to learn, it's not ridiculous to ask people to record information, but in my mind - I thought...this questionnaire is ridiculous. It is MUCH too confusing - I'll talk about my part - I should have just asked one question about HIV, and if the person's family had a case then I could follow up. AND the survey is in English - So many of the people in this room today don't read English. And why should they...they speak Kiswahili! And I just imagined...what if someone came into a room where I was and told me I'd have to give a survey to 10 people written in a language I don't speak. Oh man. I was feeling so bad about it. 

We'll see what happens - I know they'll try. If nothing else, I know that I am thinking of ways to improve the survey. 

The rest of the week, I'll blog about this weekend - did four home visits - where one lady thinks she has retained a pregnancy in her body for 10 yrs, another lady asked me to take a pic of her and then started breastfeeding her daughter for the pic, and visited 2 health facilities - it's always normal to see mosquito nets hanging over the beds right? Anyway...more to come - Soon! ;) 

Thursday, October 23, 2008

I'm drinking a Coke, and she's getting an HIV test...

Ok guys, this for real happened today! This is how it went down...

Today, I roll up to Nyamaharanya Dispensary crammed on a beat up Boda Boda (motorcycle) with the driver, me, and Eunice (my translator friend). I pray every time we are climbing a hill that the bike won't tip over. This is after a crazy fiasco of being stopped by a piece of twine! crossing the road in order to make people give money - it's some local gov't thing. 

I went to this facility to see if people from Nyametaburu are going there for services (turns out not so much), and what they are able to provide. The Nurse in charge (3 yrs training) is a very nice man named Jarvis, and a lady named Susan is an assistant Nurse (2 yrs training). Jarvis is a gov't employee, Susan is a volunteer. They have been open since August 2nd and have seen - 658 patients!!!!! 

They were gracious and answered many questions I had about the facility and the patients, Walked us all around so I could see the set up, and then they went and bought Eunice and I each a coke. Sooo kind. I called the Boda Boda to come get us, and I asked if I could sit in while he saw patients, who just WAITED until I was done asking all my questions. Incredible. Oh, P.S. when they walked us into a room there was a lady getting some IV fluid.
But the IV hanger was a Nail holding up the twine and material that equals a window curtain here, and the "bag" looks like a cleaned out plastic liter bottle. NOT KIDDING! 

And the situation in the examination room...there is ONE table given by the school (Holding EVERYTHING - the zillion record books they have to keep by hand, the couple surgical instruments they have, the vitamins, etc.)  Chairs (one chair, and 2 low stools with no backs) were given by the community, and one examination table is borrowed from another health facility. The community has done so much to supply this facility. They go fetch water every day for the dispensary's use. A volunteer stays to cook for patients. REALLY - the support is incredible, and the resources are sosososo few!

So, this is how it happened - I'm doing what I normally do, sitting there, listening to complete Kiswahili trying to take notice of things I can understand - like privacy practices, doctor care, patient response, etc. And I'm drinking my coke, taking notes, and all of a sudden the Nurse says..."She has agreed to have an HIV test." At that moment ------- what do I do? I'm honestly sitting there thinking "I am drinking a coke, and this lady's life could change as a result of this test. I'm DRINKING A COKE and she's GETTING AN HIV TEST!!!!!!!!" 

Some thoughts racing in my mind: I've never seen an HIV test be performed; I don't know how long it takes to get the result; will my boda boda arrive before the result; will I ask to stay; what would I do if it's positive; would I pray with her; is she scared; will she tell her husband; should I keep drinking my coke....

From what I had found out earlier, this facility doesn't have ARTs except for pregnant mothers, they'd have to refer her. Would she go? Would she act like it was 5 minutes before and she didn't know she had HIV? 

I hear the "Doctori" say "It will take 15 minutes to get the result." So, I'm hoping I'll be there for the result. He keeps talking to her, I'm still drinking my coke, and then he says...It is negative. 


Guys...its incredible what's happening.  People are sitting in barely functioning health facilities that are testing and treating people for life threatening diseases, and half the world is sitting there drinking a Coke! It is a BIG endeavor - equality! allocation of resources! justice! care! LOVE! I love the people who see this and check themselves. I love the ones who can't, and pray that one day they will. We're all at a different stage of life, but where you are right now -- can you DO something? I'd venture to guess you could; FIND something you want to be a part of! Something bigger than yourself. Just give yourself to it for a season, and just SEE what happens! 

** Please check out my team mates blogs - they're better writers than me, and we all talk about different events **

Thursday, October 16, 2008

How I'm doin...

It is pouring down rain right now! I can not even hear my teammates when I’m right in their face! We have a metal roof, and it’s a completely different experience when it rains.

I’m trying to think of the right update to give…when I talk to friends I always ask for updates in these areas : How are YOU doing, How is your job, How is your romantic relationship (or lack of one) doing, How are your family&friends, How is their relationship with God. So, that’s the form this update will take:

I am doing Ok. I was getting sick yesterday, really run down, but also runny nose, feeling hot, abdominal pains, little cough, and also I was frustrated. See, we’ve been here for over two weeks now (in Kuria District) and I was frustrated with the fact that I get the comments: “MZUNGU!!!!, Buy me sweet, How are you?, I’m fine, Buy me football shoes, give me 10 bop, give me your shirt, Mzungu! Mzungu! Mzungu!” Ok, now it’s not ALL the time, it’s not EVERY person, but it gets wearing – especially when they are yelling to you as you enter and exit the CHOO. I know that I am privileged, beyond belief, to come from America. It does mean that I have money – not in the sense that I actually have enough to buy and give everything that’s asked for, but I know I have been given this opportunity. See…we’re trying to break the cycle of dependency. We don’t want to be looked at as having all the answers or all the things or all the money. We want to empower! Break the stigma that the people suffering from poverty don’t have a role to play. It’s a HARD thing tho. And yesterday, I was really fed up with being yelled at. I must say, that my night totally changed when I chatted online with a friend and she gave me WONDERFUL news tho! She’s pregnant!!!! That really changed my mood!

My job – well, I am in the midst of collecting a lot of information about disease prevalence and infrastructure needs. I am thrilled to be doing it; I currently am trying to collect baseline data for a long set of metrics that will give us the, well, baseline from which to measure our program’s impact here in Nyametaburu. I usually meet with a lady name Irene, who is a pregnant mom, market owner, farmer, and involved community member. She and her son are pictured above as they walked me to their tobacco shamba. Or I observe at the health center in Nyametaburu. Nellie is the nurse aid there, and is awesome about teaching me and answering zillions of questions. All 4 of us have split up jobs around the house, mine are to do dishes, and shop with Nicole for the food we eat. The market is a story in an of itself! And washing dishes is surely funny during storms when the lights are out, and when we use only cool water and plastic basins to wash and rinse in. It’s always a laugh.

Romantic relationship – for me right now it’s the lack of one, and to be honest, I’m happy about that. (for those of you who know me, how hilarious is that statement?!) Anyway, I am blessed to be single. I know it’s for a purpose, and although I long to share my life with someone that I am in love with, right now, I’m so content. I get to enjoy witnessing an incredible Godly marriage between my two team mates – Nicole and Doug. It makes me stick to my commitment not to settle, and stick to the truth that God has a plan and a purpose for my life. Nicole and Doug are a wonderful couple, and really share the love they have for one another with anyone and everyone around them. They strive not to just let their love be between themselves, and it’s NOT! I feel it every day, and I am so blessed by it.

My family and friends – I imagine are great. I have limited contact with them, but skype my parents every Sunday, and email or on-line chat some other friends. One chat I had last night was encouraging, one friend of mine in Morgantown is truly pursuing God with all she’s got - I know others are too, but I chatted this one recently. ;) And she talked about having to make the choice of being liked by man or being obedient to God. Guess which one she chose? ;) I’m thankful to have friends in my life who are striving to live as Jesus did. It is a joy to share this journey with them – joys and pains…all of it, cause it’s all mixed together you know.

My relationship with God – well, he’s my everything! My comfort, my protector, my great love, my best friend, my shield, my joy, he’s everything to me. I am in the midst of the dream he gave me and developed for years! I am loving reading the encouraging scriptures my friend Mary collected from my Motown friends and wrote in cards for me to read on specific days while I’m here. I am fulfilled by the incredible love of God, and truly look to him daily for the strength, support, and wisdom I need for the work I was called here to do.

That me in a nutshell! ;) I’m feeling much better by the way, the sickness stuff passed, and tomorrow I am meeting with Jake to talk about my personal work plan, my team to brainstorm some things, and Joash Dudi, the Public Health Officer and employee of the Kenyan Ministry of Health. This is my life… Grace and Peace to you!

Wednesday, October 8, 2008

Today was a big day....

I have an undeniable story in the title of this email, but today was a big day! So I'll have to explain that later. Today was the biggest meeting YET for Nuru in Nyametaburu!

See, I'm doing - well what I explained in the title box of this blog - and doing it with a non-profit called Nuru International! I'm a part of the first foundation team, and that rocks my life! For a long time - as in YEARS - I've been trying to figure out "what will I be doing? how can all my passions come together? how can I live my job as a life of service?, etc." More about THAT whole thing in another blog too, but basically - it resulted in this. So ... back to today! 

I worked from our dirt floor living room/office/kitchen/dining room/entertainment center ;) area this am for several hours. Pouring over the questions I have to find out about the community. A lot having to do with specifics about their infrastructure relative to healthcare, but also questions relating to the cultural aspects of health and education to address prevention of disease. 

Nicole (one of my awesome team mates) and I left at 10am to walk to get a Boda Boda (motorcycle) to drive us down the long, windy, hilly, dusty road to Nyametaburu community. We live in Isebania, which is maybe 5-7 km from Nyametaburu. Nicole and I walk about 30 minutes talking about our ideas for the day - what we hope to achieve, observe, etc. We get to the road to Nyametaburu, and the slew of Boda Bodas waiting for business, and ask one driver how much will he charge? He says 200 shillings per person, but this is NOT our first Boda Boda ride, so we KNOW they usually charge 150 shillings. We tell him so, and he agrees to take Nicole and I both for 300 shillings. Sowa Sowa (ok). 

It's a fun ride. INCREDIBLY beautiful! Nicole and I and our back packs are on one Boda Boda going down this road. And we arrive to Nyametaburu. I'm off to the dispensary to shadow Nellie, and Nicole is off to Eunice's house to observe and ask many questions about water and sanitation. 

My entire day from 11 - 3pm is spent in a chair next to Nellie behind her desk as she sees and treats MANY patients. I saw mothers bringing babies for vaccinations; mothers coming in for their first anti-natal exam; men and women with respiratory track infections, malaria, pains from past surgeries; children with malaria; a boy with an infected wound that had to be drained; and more. Nellie had people in her office NON-STOP! and she was pleasant to all of them. We left only for 10-15 minutes Tops to go get chai and chipatis. 

MANY things are different from what I'm used to - 
  1. Privacy - for one, I was in the room - a Mzungu just there next to the nurse. Not that I understand what they are saying, bc they are speaking Kiswahili, but still. And they were fine with me being there. Also, other patients will just stroll right in to the office while the nurse is assisting someone else. The nurses 3 girls came in a couple times, sitting and waiting, bringing the baby girl to be breast-fed by Nellie - the Nurse on duty - and she breast-fed while she continued to work. Incredible dedication, and keep in mind it's just more culturally accepted. Not strange at all. 
  2. Assistance - it was just Nellie. All day! Just her! She did everything - intake, examination, record keeping, payments/receipts, pharmaceuticals, injections, education, scheduling.
  3. Availability - 1 woman mentioned she sleeps under a net, but it's not been treated with pesticides. The tablets to treat nets are in Isebania town. Not available at the dispensary or in the community there. 2 women were sent away to go buy notebooks before Nellie would see them. The notebooks (envision 20 pieces of paper folded with a slightly thicker piece of paper around it and stapled) are then torn in half to create 2 smaller notebooks. The people are responsible for their own records. Oh...
  4. Record keeping - all hand written. Nellie had a problem getting a pen that worked - I just gave her mine. The people keep their own records. The nurse or whoever sees them writes the explanation of their symptoms, the impression (what the nurse thinks they have) and the treatment. Mothers have a yellow booklet which is filled out prior to giving birth with their health info (during pregnancy) and then the babies info after birth. (Oh, every child I saw today was born at home - most likely with a Traditional Birth Attendant.) And Nellie keeps data on pregnant mothers and children in big notebooks given by the Ministry of Health.
 Nellie was gracious, explaining many things to me, and asking questions that I was interested in regarding patients - but I couldn't help but feel a little worthless. I'm taking notes, and she's treating a zillion patients. Wow!

I did observe some things that might lend to possible solutions or "points of intervention" as I'd like to call them. One being - the people wait to be seen for so long - one man was there when I arrived a little before 11am, and he didn't get seen until 1:15pm. I really think that there could be some education going on right there for people to learn about disease prevention, identification, treatment, etc.

At 3pm I walked out of the clinic to meet up with Nicole and Jake (affectionately called "Jake Nuru" as he is the CEO of Nuru and Co-founder - another awesome teammate). This meeting was the first of it's kind. We've been meeting with community leaders, elders, ministry directors, chief/sub-chiefs/assistant chiefs, and church leaders over the past 2 weeks. We've been explaining the vision of Nuru ( and explaining the plan to help their community by them partnering with us. We asked in ALL of those meetings - "invite people to come Wednesday at 3pm to learn more." That was today - and about 130 people showed up!!!! about 45 women, and 85 men. 

Jake did AWESOME! We had the counselor of the community translating for us, and he is an animated and serious motivator. The Chief was present, as was our great rafiki (friend) and Community Development Committee Chairman - Philip! It was a great meeting. Many good questions about the plan for training, farm inputs, loans, group formation, etc. The people are so excited we are there. They buy into the partnership model, knowing that this is not a hand out, that they have to work to be involved in the program, and they are willing. -- Granted, now everyone thinks I'm a doctor - which I'm not - but that'll be sorted out somehow ;) -- They want their lives to change. :) For many of them (especially the kids) this is the first time in their lives they have ever seen Mzungus (translated as Europeans - but it means white person). But they are very thankful we are here. They invite us to come to their homes, to come "greet them", to eat with them, etc. They are lovely people. And so far, we have everyone's support that we have met. ;) God is so good!!!

We are only just beginning, but today was a big day! 140 people!!!! That's big...

More to come. ;) Thanks for reading!