Christine in Kenya

Moving Mountains

Your task is to move a mountain from one end of the swamp to the other.  By moving the mountain, thousands of lives will be saved; countless others will be empowered to rise up out of poverty, and reach their fullest potential. You are given a shovel.  The earth is heavy, your steps are shaky and unsure.  Some of your load falls and is lost in the murky abyss.  Other pieces are full of rocks and you are unable to manage them with the tools at hand.  The light is dimming. Night falls.  You become lost in a curtain of darkness.  A hand reaches out, you are provided a cart.  A motor is heard in the distance, someone is operating a earth mover.  Slowly, dawn breaks on the horizon.  You are surrounded by people, some local, some from far off lands.  Together you are working side by side with people from all walks of life; some old, some young, all with a vested interest in moving the mountain across the unforgiving landscape.

The mountain may never be fully moved.  Some may succeed in transferring their loads, touching lives, raising the under-represented up, out of despair.  Others may only be here for a short time and offer only hope and encouragement, but their success should not be measured to any lesser degree.  Success is in the synergy of the whole; the doing, the caring, the giving and collaborating; the stepping out of one’s world to be there, at some level, any level, for those in need.

The People That Have Inspired

During my time here I have worked with countless people doing work that has left me inspired, energized, and hopeful for the future of this country.  Links to the nonprofits I have worked with are listed below.  Each one represents at least one person that has put in countless hours to collaborate with me either directly or indirectly to make these projects a success.

In addition, I must mention the local heroes.  The Clinical Officers, who day after day see a wide variety of patients suffering from chronic illness, acute traumas, and tropical diseases.  With only 4 short years of Medical School, these individuals bravely take on the needs and management of rural community clinics; where plumbing is a distant dream, electricity is unpredictable, and technology is limited to an old autoclave, and a stethoscope.  In lieu of radiographic means, these clinicians are experts in tactile assessments, mastering palpation, percussion, and egophony.  Life support is a warm tender hand of a family member.  Preventive medicine is based on education; oncology screenings are virtually nonexistent. On the outside, Kenya appears as a world hopelessly full of challenges. Addressing extensive health and socioeconomic needs within a country with little infrastructure, is a dire task.  However, in taking a closer look, this is a country full of inspiration; success stories based on perseverance, the tenacity of hope, and a belief that tomorrow will bring a better day.

Project Updates

Water Filters:

Sustainability is key as I wrap up my hands-on contributions to the development and expansion of the Hygiene and Sanitation Project.  With a donation of $200 we were able to travel to Nairobi and pick up 10, 20L containers with fitted ceramic filters.  These containers and filters will be distributed to the most rural clinics in Osani and Viagenco.

The limited accessibility of the Osani and Viagneco clinics was well demonstrated on our return trip home this past weekend.  This being the rainy season, long heavy rains can be counted on each evening.  We left our meetings in Osani early to start our 3 hour trip back to Kisumu.  The rains came a bit early, and the muddy, rocky roads were no match for our 40 year old Land Rover.  We found ourselves stranded in a ditch for 4 hours.  But thanks to the efforts of a priest in a pickup and Action AID (a nonprofit with a much newer Land Rover) we were able to be back in Kisumu before the wee hours of the night.

Our goal is to develop a local filter factory, which will distribute these much needed water filters to the entire Nyalenda Province.  After a tour of the Nairobi factory, I am very optimistic a similar production plant can be recreated in or around Kisumu. We are in the midst of further developing this plan and identifying key resources in Kakamega.

Soap Making:

I’m continuing to work with a local women’s soap making group supported by the OMEGA Foundation to develop small size bars that can be purchased for patient and clinic use.  We delivered ice cube trays to the village 2 weeks ago and look forward to picking up our newly made, ice-cube-sized, soap bars this week.

Dormer Bio-Tech has begun drafting a grant proposal to the Gates Foundation to for support of a local community-based soap making consortium.  I look forward to reviewing the draft and continue to collaborate with this company as we develop plans to improve the socioeconomic conditions of the local people.

Politics:

Kenya is ranked as the 6^th most corrupt government in the world (based on citizen perceptions).(REF)  As a result any plans for sustainable change must have the support and backing of key members of parliament, or else any profit gains can easily be lost long before it gets to those in most need.  To combat this phenomenon, I had the pleasure to meet with 2 members of Parliament this weekend who represent both Osani and Viagenco areas.  They were extremely supportive of our plans for both filter and soap production and will personally see to it that government processes are streamlined in order to support efficient development of these factories.

It Takes A Village:

The following are  nonprofits that I have had the pleasure to collaborate with  in the development of The OGRA Hygiene & Sanitation Program:

Direct Relief International:     http://www.directrelief.org/

Dr. Mike Marks, has held the vision of a filter factory in or around Kisumu, Kenya for over the past year.  It was his vision and guidance that has been key in my ability to advance the filter factory project.

Dormer Biotech:  http://www.dobitherapeutics.org/about.html

Dr. Anton Dormer has been an incredible support throughout most of my project development phase.  His vision, to develop a commercial soap factory in Kenya that will support the community and be a catalyst for socioeconomic change within the region.  His vision, support, and guidance has been key in advancing the soap factory concept.

Thrist-Aid: http://www.thirst-aid.org/

Curt Bradner has been a key consultant in the development t of  the filter factory concept.  His nonprofit has support the construction of 8 successful filter factories within the developing world.  His eagerness and vast knowledge in the development of colloidal silver manufacturing has been priceless.

SWAP:   http://www.swapkenya.org/

Alie Eleveld, the Program Director for SWAP Kisumu, has been a wonderful friend, and support since my early days in Kenya.  Not only does she provide our program with high quality, discounted water containers, but she has welcomed me into the nonprofit community and has placed me in touch with some key, like-minded individuals throughout  Kisumu and Kakamega.  Her efforts have been a great launching pad for the program.

OMEGA Foundation:      http://www.omfo.org/

Rose Dianga, Program Director for OMEGA Foundation, Rabour was key in introducing us to successful women’s soap making groups.  We spent much time with these strong, inspiring women and have learned far more then soap making.   I will be forever grateful to Rose for providing us the opportunity to bring these beautiful women into our project.

PATH International:   http://www.path.org/

Dimitra Patrikarakou, a consult for PATH International holds a similar vision as we do, bring water filter manufacturing to Kisumu.  Through challenging Skype sessions Dimitra has been a great support and guidance.  Her group will provide the marketing analysis of the area, and will assist us developing a full marketing plan for the water filters.

Action AID:   http://www.actionaid.org/

Thanks to Action AID’s local driver, who on a very rainy night decided not to take the ferry but instead drive around the lake.  I will be forever grateful.  He patiently waited while we were pulled free, only to find that he too was stuck in the mud.  Fortunately his Land Rover incurred no damage and he kindly provided us the 2 hour ride back to Kisumu.

ACCUMEN FUND:    http://www.acumenfund.org/

As a newer member of this group, I’m excited, anticipating the contributions and education that this talented, worldly, and widely experienced team of experts can provide our program.  The discussion boards are awe inspiring.  Its members have boundless energy, hope, and vision for a better tomorrow.  I look forward to continuing to be a part of this group, as I learn and grow with in the nonprofit sector.

Photos From the Week

Visiting Filter Factory in Nairobi: http://picasaweb.google.com/researchrn68/FilterFactoryInNairobi#

Osani Clinic Garden: http://picasaweb.google.com/researchrn68/OsaniClinicGarden#

Meeting Members of Parliament: http://picasaweb.google.com/researchrn68/MeetingMembersOfKenyaSNationalParliament#

Visiting the Minister’s Estate: http://picasaweb.google.com/researchrn68/TheMinisterSEstate#

Ground Breaking for Sugar Cane Refinery: http://picasaweb.google.com/researchrn68/GroundBreakingForSugarCaneRefinery#

Kenya: The Challenge

A mother awakes to the sound of her young child’s cry. Food and potable water are scarce. It’s the dry season, but the unexpected rains have caused flooding, creating a rise in cholera and malaria counts. The young one is feverish, with sullen eyes and parched skin from days of thirst. The only available water from the neighboring lake and streams has long been infested with human and animal waste. 

Scenarios such as this one is played out everyday within the thatched huts and corrugated steal shacks of Kisumu, Kenya. Children are dying of diseases which have long since been combated in the industrialized world, through effective hygiene and sanitation programs. However, in the third world, simple bacteria plague the fragile immune systems of the young, causing grave diarrheas, dehydration, and subsequent death. Simple soap and water could wash away 80% of the bacterial infections that are killing the children of Kenya. It is these unacceptable facts that drive my burning desire for change. My secondment is officially complete in 6 weeks, but Kenya is in my heart forever. I will remain committed to efforts which will provide potable water and soap to the children of this region. I will champion programs which will bring water filters, soap and education as well as improved health care to the people of this region. We are a global brotherhood, and this needless suffering cannot be ignored.

Kenya: The Inspiration

 Among the sickness, poverty, starvation and filth there exists bright rays of hope, which can be seen in the darkest moments. The people here are accepting of their daily struggles and find an inner strength that few of us in more privileged circumstances will ever acquire. It is the rare stranger that will pass you on the street without a warm greeting or kind word. A visit with local friends will typically end with a small gift being bestowed upon you. There is much joy and inspiration which, like a seedlings struggling to survive between the cracks of a sidewalk, will preserver with an unmatched tenacity unknown in the developed world.  It is this strength that keeps Kenya alive.

The Wedding 

There is a fine, almost undetectable line between friends and family in Kenya. Ed and I have developed an extended network of close friends who have accepted us as one of their own. When word grew throughout our close-knit community that an American wedding was in the works for us back home, our Kenyan friends quickly offered up their services for a Kenyan style affair. Before we knew it, Ed and I were in tow as our good friend Francis made all the arrangements for Kenyan nuptials. Kenyan weddings are something to behold. As in the States, they are centered around good friends, good food, and most importantly a public affirmation into a holy covenant. Ed wore a traditional Kenyan top, and was given the opportunity to thoroughly look over the bride to ensure his high standards were met. This is an old Kenyan custom which guards against the bride’s family from switching the betrothed to a less desirable sister or cousin. Upon his approval, and roars of laughter from the audience, we stated our vows, and then held each other’s hands up high in the air as we placed handmade wooden rings on our fingers. After a formal signing of the wedding certificates we were finally announced ‘Husband and Man…’ err ‘Husband and Wife’ (I guess the Pastor was a bit nervous too). After the ceremony we feasted on traditional fare of sukuma wiki, pilau and rice. After the wedding we took a few days respite to Kakamega Forest, the only rain forest remaining in Kenya and home to a variety of monkeys, birds, and beautiful foliage. It was the perfect get away for us, full of great hikes followed by afternoon teas on the veranda. It was difficult to say our goodbyes for another 6 weeks, as Ed headed back to the States; but we know in our hearts the importance of this project. His love and support as been the keystone to my achievements here and I’m so blessed to have him in my life. I look forward to our lifetime of love, hope, and rewarding adventures.

 Hygiene and Sanitation Project

 “Just because you can see the station, doesn’t mean you have arrived.” Maya Angelou

I am down to a mere 40 some days before I must prepare to board a plane and head back to my life in the US. There is still so much to be done but with the gracious help of my GSK colleagues, friends and family I know this work will carry on long after I’m settled in my life in the States.  Many thanks to my GSK colleagues, Rebecca Harvey and Tom Whipps who sponsored an additional hand wash station at the Joel Omino School (this school services over 1500 students from a nearby slum area). With the support of friends and family back home a hand washing and fresh water station was installed in Osani Clinic, a very remote clinic about an hour south of Homa Bay. We also are preparing to install 5 more hand washing stations in Ombeyi Clinic, a clinic that services a remote village, which due to recent rains, travel to and from the village has become almost impossible.

Sustainability Program:

The sustainability side of the project is still growing, and networking seems to be the key. It is my hope, before I leave in April that we will have put together a business plan for a soap factory in Kisumu. Proceeds from this factory would support the OGRA Hygiene and Sanitation Program.

Knowing nothing about factory development, soap manufacturing or establishing a business in the developing world, I have successful pulled together an expert team who has offered great guidance. The synergy from our various talents to date has been amazing. I hope within the next month to meet with Kenya Industrial Research Development Institute (KIRDI), and an expert from the University of Nairobi. I have had a brief meeting with a board member from the Kenya Manufacturing Association, and he has agreed to donate his time and expertise as a consultant. With the help of Sud Bar Soap in the US, I have been able to take a local soap recipe and develop it further. It is our hope this recipe will soon be put to use by soap making groups established within schools and clinics; thereby  making soap available to those most at risk for high morbidity and mortality due to bacterial infections.

To mirror the soap factory efforts, we are also developing plans for a local filter factory. I’m working with Thirst-Aid International who has established 8 successful filter factories in the Middle East. PATH International will be doing a marketing analysis of the filters in the Nyanza Province throughout this year. SWAP (Sanitation Water and AIDs Prevention) has offered to market the products. I met with a local pottery group who may have the available land. Clay samples have been sent to the US for analysis. Now the final piece is to complete the overall business plan and seek funding for the building of 3 kilns, which will enable the manufacture of 20-30 filters on a daily basis, which will be sold at low cost to those in need throughout the Province. Together the filter and soap factory will make locally available those critical elements that we in the industrialized world take so much granite; fresh water and soap.

A Final Note;

 So many of you have expressed an interest in taking a hiatus from your day-to-day life and take the leap into nonprofit work in a developing country such as Kenya. I highly encourage you to follow your dream. Although this work comes with its share of steep learning curves, if you find this type of work to be your passion, the rewards can be endless.  

“Do not go where the path may lead, go instead where there is no path, and leave a trail “   Ralph Waldo Emerson

Pictures:

Ed’s Second Visit : ) http://picasaweb.google.com/researchrn68/February2010EdVisit#

Wedding : )

http://picasaweb.google.com/researchrn68/Wedding#

Women of Rabuor: OMEGA Foundation Soap Making Group http://picasaweb.google.com/researchrn68/OMEGASoapMakingWomenSGroup#

The main focus since my return to Kenya, is to establish a sustainability plan; my hope that the momentum of the projects that  have been ignited with the team at OGRA will continue to evolve, to meet the needs of the various communities I’ve  grown to adore.  In collaboration with the OGRA Clinical Director, we have started a continued medical educational program at the local clinic in Ombeyi.   After delivering several presentations on Pediatric Emergency Treatment, and Infection Control Measures, we have begun to empower the staff at the clinic, challenging each of them to present on a healthcare topic of interest.  This is an exciting challenge for them, as few of them have ever had the opportunity to prepare and present a professional presentation. This project also addresses the need for continued medical education opportunities within the Ombeyi Clinic, a need that is common throughout this part of the world.  Unlike the industrialized world, access to CMEs through internet connections and professional mailings is nonexistent here.  The Ministry of Health holds professional education meetings, however due to the costs; few have the opportunity to attend. 

 A typical clinic staff consists of 2 Clinical Officers, several nurses, lab technicians and community health workers.  One physician oversees the care within the clinic which can see up to 40 patients a day.  In this model a lot of responsibility weighs on the Clinical Officer, who after 4 years of training, must prescribe drugs and make medical decisions which are typically left to those with twice the number of years of training in States.  I look forward to the next couple of months as I continue to grow and learn alongside the Clinic Officers and their staff as they take on more of a leadership role in offering continued medical education and training programs to their staff.  I hope to also start a visiting nurse and physician program within OGRA.  Whereby clinicians worldwide can come to OGRA for a week or two, and share with the clinic staff their skills and knowledge.

In addition to creating educational programs for those working within the clinics, I was recently asked by the local medical institute to teach 2 classes this semester.  Early in January, I began teaching courses in Embryology and Basics Nursing Skills.  After completing my first couple of weeks, I have no doubt Kenya will be in good hands with this next generation of clinicians.  These students come to class with energy and eagerness to learn that surpasses anything I’ve ever experienced.  I’m finding teaching particularly energizing and look forward to seeing a whole new prospective of Kenya this semester through the eyes of these students.

The Hygiene Program continues to move forward as we work through the first drafts of a business plan for a soap factory, and brain storm on a chicken and garden program in the local villages.  It is our hope that with a sustainable garden and chicken program, the expenses of the hygiene program will not become too burdensome for the local communities. 

Another highlight these past few weeks was an article published by the Global Atlanta which included an interview they had conducted with me back in December.  Hopefully this will bring a little more addition to the basic hygiene needs in this area.

 In addition, I was given permission to set up a Hygiene Program web page within the OGRA Foundation website.  January was the official launch of the website, which drew a lot of excitement from our local team. We hope the article along with the website will bring much needed attention to the hygienic needs of these communities. 

Global Atlanta Article:  http://www.globalatlanta.com/article/23683/

Pictures:  Stay Tuned To Be Posted Soon!

Overall my life in Kisumu Kenya is about as far removed from my little world in suburban Philadelphia as it could get, and the jump from one world to the other is as emotionally exhausting as it is physically. I arrived home in December just during the peak of the Christmas hustle and bustle. The materialistic mantras of the season, with advertisers hawking their latest and greatest technical gadgets and toys left me feeling numb and disillusioned. After being in Kenya for a little over 2 months now, I have grown to realize not only the great monetary divide that exists worldwide, but the aspects of hope for a better tomorrow that comes with financial stability. For those of us that are blessed to live in a stable environment, where fresh water flows from our faucets, and education and healthcare are easily accessible , hope comes easy. However with these luxuries comes a price, the responsibility to reach out to those less fortunate whose hope is lost in the day-to-day struggle to survive. I have heard first hand accounts of how one sponsor can lift one child out of poverty, providing him the opportunity to go to school, get educated and move on to higher education and with continued support attend a university. I have learned of one child, lifted up by one sponsor who went on to receive a medical degree, and with that degree, returned to his homeland to start a nonprofit that reaches out to thousands of impoverished people. That one child is my boss. A Kenyan physician, who after being trained in London came back to Kenya to form OGRA, a nonprofit that is doing incredible work for the people of the Lake Shore Region of Kenya. I am so privileged to be working for such a brilliant man, along with a carefully selected staff of some of the most intelligent and talented professionals in Kenya. I have learned so much, and I am delighted to be back for another round of learning, sharing, struggle and frustration. This is the continued story of my life in Kenya.

The Glue Boy

Shortly after returning from holiday break I made my weekly visit downtown to stock up on supplies. As usual, the Glue Boy was waiting for me. As soon as he spots the fair-skinned women with the red backpack he knows there’s a chance for a Zone bar or crackers. The Glue Boy, shoeless and covered in road dust, easily blends into his surroundings, making it easy for most people to pass him by. He sits day after day holding a soda bottle up to his nose, inhaling industrialized strength glue obtained from a nearby furniture maker. He is one of thousands in Kisumu, most likely a street child orphaned from the AIDs epidemic. Of those children I spot on a daily basis, this fellow stands out. He is one of the few that is still full of vigor, with a charming smile that reflects the residues of a childhood lost. I had to respond to his energetic greeting yesterday by telling him I had no food with me to share. He smiled and quickly challenged me to a 2 minute run to the market, “OK, Mzungu, 2 minutes, you be back in 2 minutes, I’ll be timing you!” It made the local vendors chuckle as they spotted this crazy white women fending off a busy intersection of tuk tuks to get some biscuits and nuts. As I played this game I wondered how many others have come before. How many other aid workers from far off lands have come with the hope that if they could do something to stop the hunger pains just for a little while in one child then perhaps their trip would have been worth it. This is life in Kisumu.

Below is an excellent video providing an overview of the glue sniffing street children of Nairobi. The sights and sounds that you see in the video are very similar to that of Kisumu, the city where my glue boy greets me every weekend. http://www.manythings.org/b/e/259

Hygiene Project Update

This week we welcomed two new members of team, Loren Nakamura from the US and Paola from Italy. Both come with a large amount of energy and ideas to advance the projects even further. We really welcome their fresh ideas and enthusiasm. Monday I toured the OGRA sites with Loren and Paola and paid a visit to each hand washing station we set up in the Fall. It appears all of them are well used and appreciated by the sites. A huge thank you to my good friend Ira Rubinstein for sending me soap, they came in very handy in resupplying a village clinic that had already ran out of their 2 month supply.

 I’m anxiously working with the team in putting together a sustainability plan to keep a stable supply of soap available to these sites. I had the privilege in meeting a with a women’s group in the local area that makes and markets soap. After all the soap making programs I’ve reviewed the soap recipe used by this women’s group seems the most transferrable to the local villages I working with. Other plans include a chicken project for raising roasters and eggs . Loren, in the short week he’s been here, has really devoted a lot of energy to developing the chicken project and I look forward to continue to work with him to bring these sustainability plans to fruition.

Sharing my experiences with each of you, and reading your caring, thoughtful comments and questions have brought so much more meaning to my work here.  Thank you again for all your continued support, prayers and well wishes. 

Pictures From the Week: http://picasaweb.google.com/researchrn68/Week14#

Another couple of busy weeks are coming to completion here in Kisumu, Kenya and the endless list of needs seems to be ever increasing.  I’ve been doing a bit of traveling to assess some remote communities which vary from the hard to reach Oyamo Island with no local clinic (see link to pictures below), to a village called Ombeyi where a standard clinic exists but it is in need of some basic clinical enhancements.  I hope to get back to each of these communities after the holidays and work with the locals in building sustainable programs for hygiene, fresh water, and improved health care.  It’s a tall order for the 3 months that remain, but I believe with the outstanding team that I’m with, the momentum for change can begin as others take the torch and run with it come April.

The highlight of the past few weeks was a long awaited visit from Ed, my nearest and dearest support throughout this whole adventure.  I honestly don’t know how I could have gotten through all the adjustments and transitions without his love and support.  I was able to take a few days off while Ed was here and actually got to see Kenya from a tourist’s perspective (see link below for pictures of safari and various side trips!).  After Ed’s departure my thoughts were full of loved ones back home.  (I’ll be in the states from December 13^th to January 7th!)

Project Update:

The hygiene project continues to gain momentum as the newly installed hand washing stations and fresh water containers are gaining popularity.  The cholera epidemic in the northeast regions has many seeking programs that can combat similar disparities here in the west.  A national radio station from Nairobi contacted us last week and requested that we perform a one hour weekly broadcast on hygiene and fresh water.  It was quite flattering to receive the invite, but the logistics of getting to Nairobi for weekly broadcasts, in addition to the need for an interpreter (the radio station caters to those speaking the local tribal language of Luo) seemed like a challenge that would easily divert us from the hands on work in the villages and slum areas.   To date we have implemented the hygiene education in two clinics, a large primary school and an orphan feeding center.  We hope to expand the program to two additional communities (Oyamo Island, Osani Village) when I return in January.  I have had a bio-tech in the states, Dormer-Biotech recently contact me with a keen interest in helping us apply for funds to expand the program and eventually build a soap factory, whose proceeds would support the continued needs of this program.  In addition, I am also working with Direct Relief to investigate the feasibility of a water filter factory, which will eventually provide yet another means  of financial support.  It will be truly amazing to see this vision become reality in the years to come.

As the OGRA Foundation develops it long term goals, I worked with a small team within the organization to construct a formal Strategic Plan which we hope will enhance the vision, and provide a keen focus over the next several years.  As an adjunct to this I’ve been working with clinicians and village chiefs in 3 unique communities to build an understanding of their barriers to care and establish short and long term goals to overcome them.  I hope over the course of several months to put together project plans which will not only address their critical needs, but will provide sustainable funding through community programs(e.g. community gardens, crafts) .  

 I had the pleasure to join a small team of key authors in the development of a large grant proposal to the Elizabeth Glasor Fund.  We hope to hear a reply next week,  and have funds available in January, which will support a large-scale HIV/AIDs prevention and treatment program which will enable us  to touch the lives of nearly 10,000 men, women and children at risk for or suffering from this endemic disease.

Final Note:

This time of year we are reminded of the values of togetherness with friends and family.  It is these gifts that truly matter as we construct meaning to our lives.  Thank you for allowing me to feel apart of your lives, even though we are so many miles apart, I value the friendships and connections I have with each and every one of you.

From the people of the villages that I support I’d like to extend a big Thank You, to each and everyone back home.  With each visit, I remind the villagers that I represent many, many people  who wish them well and keep them in their thoughts, and that alone can be very powerful to those in need. 

Have a wonderful holiday season, and I look forward to sharing more adventures with you in New Year !

Pictures:

Ed’s Arrival:

http://picasaweb.google.com/researchrn68/EdArrivesToKenya#

LaSavannah Lodge: Home Base for 6 months:

http://picasaweb.google.com/researchrn68/HangingAtLaSavannahLodge#

Touring the Area, Grandma Obama’s House

http://picasaweb.google.com/researchrn68/SightSeeingWithEd#

Oyamo Island Community Assessment & Home Stead Visits

http://picasaweb.google.com/researchrn68/Day1OnOyamoIsland#

http://picasaweb.google.com/researchrn68/Day2OyamoIsland#

Safari Weekend in Lake Nakuru National Park

http://picasaweb.google.com/researchrn68/Day1SafariWeekend#

http://picasaweb.google.com/researchrn68/Day2SafariWeekend#

Menengai Crater: Side Trip While Heading Home From Nakuru

http://picasaweb.google.com/researchrn68/Day3MenengaiCrater#

Quick Stop At Impala Park Before Ed Heads Home

http://picasaweb.google.com/researchrn68/ImpalaPark#

 The first month of my 6 month volunteer partnership  is complete and already this experience has made a significant impact on my life.  The relationships, friendships, and projects that have been built in this short time frame is mind boggling and their effects will stay with me for a life time.  During this time I have learned to slow down and enjoy the soft slow sunsets outside my window, and the silent graceful flights of the birds that fill my sky at dusk.  In this short time I have learned the power of patient listening and the rewards that are gained by taking the time to understand the world through another’s eyes, no matter how different and strange their world may be. 

I took time this week to visit the Kisumu Museum which is a short walk to where I’m staying and offers a simple but educational prospective on the local tribes and cultures of this region of Kenya.  The main tribe of the coastal region of Victoria Lake is the Luo tribe, which migrated from the Nile Valley during the 15^th century.  Traditionally the Luo people were fisherman, a livelihood that is still evident today as the street markets are filled with sun dried tilapias and nile perch.  Historically the men would marry a number of wives, which would be a sign of prosperity and carry with it a high ranking within the village.  This is still practiced to some extent in the area today, but it seems to be limited to outlying villages of the region.  

Hygiene Project

 After many long, sleepless nights of writing up proposals, lesson plans and budgets my dream has finally become reality.   Last Thursday we arrived at the Joel Omino School, a primary school which services the Nyalenda slum community.  Supplies for the wash stations had already been delivered and the children had been briefed on the lesson plan I sent several weeks ago.  Together we sang the simple hand washing song and the children listen with full attention has we explained the need for good hygiene.  They washed with delight and continued singing until the last hand was sparkling clean  (see link to video). 

I am still in awe at just how quickly this program got off the ground.  I owe the success of this program to the many talented people that have helped me along the way.  Nerissa Simon and Massimo Taurasi two colleagues working with me at the OGRA Foundation, quickly got on board and joined me at my Hygiene Program launch at the Joel Omino school.  Francis Kadiri of the OGRA Foundation has been working very closely with me since I was ready to implement this program and has become my right hand man when it comes to getting appointments with key people, finding the best priced soaps and water containers, and translating my program into Kswahili or Luo for the younger children (most children don’t learn English until they enter Primary School).  The love and support from my family and friends has really helped ease the pains of adjusting to a foreign world and has given me the strength and focus to keep moving forward to make this program a reality.  If there was a key lesson I learned from taking this program from planning to implementation it is that it truly takes a team to instill change , and I am so very fortunate to have so many wonderful people both in my professional and personal life that have supported me along the way.  Thank you.

UTube Link for Debut of OGRA Foundation Hygiene Program: http://www.youtube.com/watch?v=4fO74vBZTSk

 Pictures: http://picasaweb.google.com/researchrn68/20091107#

There are so many key highlights from this week that its difficult to know where to begin.  I believe the most impactful event this week was the visit to Oyamo Island, about a one and half hour car/boat ride from Kisumu.   If there ever was a place that would make an American  feel blessed  to be living in such a prosperous country, this would be the place.  Oyamo is a world with no fresh water, no electricity,  and no formal infrastructure.  There is one clinic, staffed by one clinician who provides care to this island community of 2,000.   There is no market or stores of any kind.  Food is acquired either through gardening on very rocky soil or fishing in waters teeming with both cholera and local pirates.  Most, if not all the adult population is HIV positive.  The children suffer from diarrhea and respiratory infections quite regularly.  Severe malaria  in both the very young and pregnant women accounts for very high mortality rates in both these populations.  To improve on the rates of malaria, bed nets have been distributed throughout the community, but only 25% percent of this population actually use these nets as mosquito barriers.  Most of the bed nets are sown together to form rather large fishing nets (see pics), which support their only means of income.

As in most communities I have visited in Kenya, the intervention needs for Oyamo is overwhelming.  However, the quickest, easiest, and most impactful intervention would be to create a sustainable means of fresh water.  I consulted with Dr. Mike Marks, Medical Advisor to Africa for the Direct Relief Foundation, on best practices in approaching this problem.  Dr. Marks is currently researching a broad  scale approach to creating  sustainable fresh water sources throughout all of Africa, and is a wealth of knowledge on the region and its people.   He is currently researching the feasibility of ceramic filters.  These discs, when placed in large water barrels, filter out bacteria and other contaminates for up to 10 years. He is very interested in me piloting this concept on the island.  I will be developing a proposal this week along with a budget, and hope to obtain funding to launch this program before I leave for Christmas break.

Hygiene Project in Nyalenda

The Nyalenda hygiene project continues to move at a excellent pace.  This coming week I will begin an education program in 2 primary schools, 2 clinics and the orphan feeding center.  This program will be greatly enhanced by the teaching plans and tools donated by GSK Global Community Partnerships.

Along with the education program I will be setting up 6 wash stations between all 5 target locations.  The wash station for the orphan feeding center will be large enough to provide fresh water for drinking, cooking and washing, which will significantly improve the health risks for these children.

I had an excellent networking meeting with the regional Project Officer of Kenya Water for Health Organization (KWAHO) this past week.  This nonprofit has launched several large-scale distribution programs for Sodis bottles throughout Kenya.  These bottles, made out of  PET material purifies water through exposure to sunlight. As a result of this meeting,  OGRA will now be teaming up with KWAHO to provide both hygiene education and Sodis bottles distribution throughout  the Nyalenda slums.

The most unusual networking experience this week came on Saturday evening when I found that sitting at a table next to me was an entire MTV production crew.  Seeing a great opportunity to publicize the needs of the Orphan Feeding Center, I didn’t think twice and before I knew it, I found myself chatting away with the group about the devastating conditions these orphans must overcome daily.  The crew was captivated and very interested in the hygiene program, but were only in town for 2 days.  A valiant effort was put forth on their part to get the Center on the filming schedule, however due to the rains the filming schedule was already running behind and an extra shoot just couldn’t be added.   I must say, it was quite exciting to at least come close to providing the Orphan Center the air time it deserves and perhaps give Madonna a run for her money : )

Pictures for the week: http://picasaweb.google.com/researchrn68/20091030#

A busy week at the OGRA Foundation , things move so quickly in this small organization that I have to stop and take a breath sometimes. 

So far the weather has been wonderful.  Each morning there is bright sunshine which goes well with a good cup of coffee.  At the end of the day I look forward to brillant sunsets over  the lake in which the sky turns to vivid reds and oranges (see pics).  We started our short rainy season here this month, which means in the early evening  you can expect a quickpassing shower.  Otherwise, our day time weather is much like that of the Northeast in August, warm and humid.

 I took several walks down town this week which were wonderful.  The roads are either well aged asphalt, or dirt, which makes the dust from passing cars pretty thick.  Down town the market place is packed with shoppers and merchants.  There are piles of salted fish (tilapia, Nile trout and these small minnow-like fish called fingerlings.  As you can imagine a lot of the cuisine includes fish and fresh produce from the area.  I can’t say I have acquired much a taste for the fingerlings yet.  They tend to cook them up whole (like sardines) and combine with tomatoes, potatoes, whatever vegetables are available.  The juice from the fish adds flavor to the entire dish, which is a bit too fishy for my liking. One dish I really enjoy is cum-a-su-leaky (sp?).   They sauté onions and tomatoes in a pan and then add kale (sometimes spinach) and a dash of salt.  The dish is wonderful !!  I have enjoyed it so much that the chef of the hotel invited me into his kitchen to teach me how it’s made (pictures are soon to come).  Another dish which is of interest is ugali.  This is made from maze meal (or corn flour).  It’s pretty much the consistency of cream of wheat when its been left in a bowl too long and dries into a solid lump.  They serve this lump with just about every meal, and I’m told they fortify it with beans and serve it in the orphanages and feeding centers. 

One of the major highlights of the week was the boat ride to Hippo Point (see pictures).  We saw one hippo who was pretty well submerged in the water.  I’m told that the early mornings are the best time to spot them, so I think another boat ride is in order to get a better glimpse of one.

 Hygiene Project Update

Word of my hygiene program is getting out among the community.  I have been approached several times by the head master at the middle school which serves the Nyalenda slum community.  Although poor sanitation  doesn’t appear to cause the same high rates of morbidity and mortality in the older children as that in the young, there is still a great need to work with these students.   I hope to get a hygiene program started at this school after the holidays.  I also was approached by a representative from the Christian Relief Fund who is running a hygiene program in a nearby community.  I hope to meet with him in the next day or two and share some ideas and thoughts.  During breakfast on Saturday morning, Julia, from Life for Children Ministries introduced herself.  She oversees a clinic and several community outreach programs for a village about an hour outside of Kisumu.  I’ll be sending both the hygiene and malaria programs to her for use within her community.  On a side note Julia is from Lancaster, PA.  Just goes to show what a small world this really is!

Off to start another busy week on this side of the world.  I will be posting about weekly at this point to keep everyone updated on my life in Kisumu.  Keep the emails coming and thanks so much for all your prayers and words of encourage, they have been invaluable.

Christine

Pictures from School visits: http://picasaweb.google.com/researchrn68/Week2#

Weekend photos from walk to the lake:  http://picasaweb.google.com/researchrn68/20091024#

Its been a very busy week for me as I’m working on writing up proposals for the hygiene and malaria programs and meeting with all the key people.  I took some time out yesterday and today for some sight seeing with members from the nonprofit group (OGRA).  We went to a local natural wildlife preserve which was very beautiful (see link below for pictures).  

I’m still in disbelief over the number of small shacks (not much bigger than 6 foot square) which are scattered along the hillsides and all along the roads.  Those that live in shacks along the roadways are usually marketing some type of produce or meat.  These make shift meat markets are yet  another eye opener.  Imagine if you can a large hind quarter of beef hanging by a meat hook in old run down shack (no refrigeration of course) and a hand written sign saying Butcher shop – hmmmm, a far cry from the Harleysville Giant : )

Update on Hygiene Program

The leading causes of mortality in Kenyan children are diarrhea and pneumonia; rates of these diseases have progressively increased over the last decade.  Most vulnerable for these diseases are children who are born to uneducated mothers in poor, urban areas,  a population common to the Nyalenda Slums of Kisumu.  Rates of diarrhea can decrease as much as 50% in households with children who have received hand washing education and soap.  Based on these findings I have written a proposal to begin a hand washing education program to the children of Nyalenda which would be run out of the 2 local clinics.  I presented this proposal last week to the heads of OGRA  who were very energized to get it started and expand the program.  So not only will I be working out of the local clinic but I will be touring 3 local schools (approx. 1,000 children) in the area that service the Nyalenda community.  I met with one of the school officials today who is anxious to have me visit the school this week and begin preparations for introducing the program to primary and secondary school students.  I should not here that in Kenya there is a fee to send your children to school beyond primary school, however one nonprofit group runs a very successful middle school which is free to the inhabitants of Nyalenda.  I had the pleasure of meeting some of the heads of these very small but impactful nonprofits and I’m so impressed with their abilities to create so much hope out of so little. 

Pictures!

Yes, I finally got my pictures uploaded!  The first  few pictures are from the Nyalenda slum area and the clinic that is located there (this is where I’ll be launching the hygiene program).  The more rural pictures marked ‘village’  are from the countryside, about 30-40 mins. from the slum area (this is the village I’d like to start the anti-malaria program).  After those pictures, you’ll see a set from the OGRA feeding center (kids dressed in uniform).  These kids are orphans (primarily orphaned from the AIDs epidemic) and come to the feeding center twice a day for a meal.  There is a great need to build an orphanage for this community, so I hope in my time here I can work with the community to develop ways to raise money to make that happen. Near the end of the pictures you’ll see shots from the animal preserve.  Mixed up in the group of pictures is a picture of one of the secretaries from GSK – not sure how she got in the mix, the picture was taken in the office a while ago and some how it kept reappearing in these group of photos- she’s not in Kenya but would probably would like to be : ) but hey its just another memory of home, Enjoy!

http://picasaweb.google.com/researchrn68/StarredPhotos#

Seeing the Kenyan slums first hand is a riveting experience, which far surpasses anything I have ever seen in the states.  The Nyalenda slums of Kenya make up the second largest slum in this country.  Road side shacks provide shelter for people and their animals alike.  Needless to say treatable diseases like cholera are killing off the young and old as are AIDs, malaria, TB and countless other communicable diseases.  There is no government aid for these people, no welfare, WIC, subsidized housing or Medicare/Medicaid.  Seeing a world without any government supported healthcare creates circumstances beyond words.

The OGRA Foundation has offered a ray of hope in joining hands with other outreach organizations to support a small clinic which offers a pharmacy, health checks and an educational/support program for those suffering with AIDs.

Another ray of hope in this region is the OGRA Foundation’s International School of Medicine and Applied Technology (IMAT) which offers 2-3 year degrees in social work, community health development, and computer engineering.  Most notable is their 4-year program in Clinical Medicine.  Graduates from this program act as clinicians, visiting with patients, and prescribing medications in  2 OGRA supported clinics, one of which is located in the slum area, the other is in a far outlying village.

The most touching ray of hope is the OGRA Orphanage Feeding Center located in a rural village outside of of Kisumu.  The center provides 2 meals a day to up to 40 children registered in the program.  Many of these children have lost both parents to AIDs and are left with elderly grandparents or extended family members who are unable to fully support them both financially and emotionally.  A needs assessment of this area has proven that this program needs to be expanded to meet the  needs of over 1,000 orphaned children within the village.  Caregivers of these children and village elders are very supportive of opening an orphanage, however, there must be a sustainable source of income to adequately support the subsequent, ongoing maintaince costs in running an orphanage.

Some Solutions:

The Slums: There a number of programs in place to  focus on the waste management and water treatment problem in the Kenyan slums, however their impact is very limited as evidenced by the growing cholera epidemic throughout the region (Red Cross, 2009).

Within these slums, the OGRA clinic sees about 40 patients a day for a variety of health concerns.  By virtue of these patients visiting the clinic they have demonstrated a trust in receiving clinic-based healthcare, and have demonstrated an interest in self management of their health or the health of a loved one.  This population represents an excellent starting point to target a basic hygiene and malaria education program.

The hygiene program will focus on two areas, clean drinking water and effective hand washing.  A cheap and easy solution for clean drinking water may be achieved by introducing PET bottles into the community.  These bottles  made by SODIS ( http://www.sodis.ch/index_EN ) has a purification process which  is activated through sun light and is complete in just 6 hours.

Soap appears to be an unknown commodity in the this region, but could be a cheap, and easy means to saving lives.  The Global Soap Project is a small nonprofit which collects used soap from hotel chains across America.  These soap bars are melted down, sanitized and reformed into bars for distribution throughout refugee camps in Kenya and Uganda.  The first shipment of these bars are due this month to refugee camps in the region.  The slum populations present similar health risks and may be an excellent candidate for this distribution as well.

Malaria Education: Effective malaria programs vary with each region and may be influenced by the feeding habits of the specific mosquito genus known to that region, the topography of the area, and the related behavoiral habits of the inhabitants.  Within the rural village outside of Kisumu there are apparent opportunities for improvements related to mosquito exposure, these include reducing the number of stagnant pools of water, improving the use of bednets and covering to the roof eaves and windows.  A more thorough assessment of the area in conjunction with home assessments of current and recent cases brought into the clinic may be an effective means to understanding the culture within the village related to mosquito control methods.

Orphanage Feeding Center Expansion:   Seeking a sustainable source of income to expand and support an orphanage creates a huge challenge, so for this and many other solutions I’m calling on my many creative and thoughtful friends.  If you know of any programs, can think of any novel means by which this population can raise money for this vitally important project, please make a posting to the comment section.

“Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has”  Margaret Meade

Additional  Information:

Red Cross, 2009 report on cholera; http://www.kenyaredcross.org/images/pdf%27s/Appeal_for_Cholera%20_response_%20March_%202009.pdf)

Global Soap Project: http://atlanta.daybooknetwork.com/story/2009/10/07/25583global-handwashing.shtml