Notes from the Field 2009

Well here I am, about a third of the way into the final flight of my journey home to Minneapolis, and taking the opportunity to zone out and catch my breath a bit. As expected, my final days in Kenya were full to the brim with teaching, spending quality time with the kids, taking the opportunity to see a few of the sights of Mombasa, and getting mentally prepared for home. Saying the past seven weeks flew by would not be an honest statement, but I am still left with this indescribable feeling of my field experience being over, and unsure of how I will respond to the return to "normal" life. Perhaps a description of my past week in Mtwapa can assist in explaining my sentiments.

On Thursday of last week, I took off in the late morning on my own to go to Haller Park, a Kenyan Wildlife Refuge just a short matatu ride from Mtwapa. Since I didn't take a safari during my time in the country (perhaps next time), I had to see African animals somehow. I was thoroughly impressed with this facility, a former quarry for the Bamburi cement company, and how they had restored the habitat to keep hippos, giraffes, monkeys, crocodiles, and massive hundred-year-old turtles. In addition to taking photos of all the animals, I posed for a few too with the giraffes and turtles. It's not every day that you can get that up close and personal with a creature several times your size! In addition to appreciating the fresh air, I was encouraged by the tour guide who was excited that I was teaching the HIV awareness course. He is of the mindset that the culture of Kenya is changing, and that people are not afraid to talk about the disease. I hope that this is in fact the case, and that small projects such as this field experience can add momentum to further open the HIV dialogue.

PS- photos to be uploaded Monday

Continue reading "Thoughts from high above the Atlantic Ocean" »

Posted at 7:37 PM | Permalink | Comments (2)

I can certainly sense my trip is winding down, simply by the fact that I feel this past week has been my most productive yet. Of course, being productive also means I haven't touched a computer at an internet café since my last blog, so today I had to return to Dormans, the starbucks of Kenya, to be alone and actually get some work done. It's ironic I suppose; I'm finally feeling like the project is progressing, Mtwapa is appearing quite inhabitable, and yet I'm running away to the European hideaway with only six more days before I'm back to this sort of daily life. Nonetheless, a blog is necessary. So without further ado, the following is an attempt to share the story of my past week in Mtwapa.

I remember telling you last time that our 'family' now consists of 11 people; but here's a little more about the household dynamics. Christine, Fisher, Destine, Noel, and I are there just as we have been for the prior weeks of my trip. Ed and Sophie arrived last Tuesday to work at Jambo Jipya and are from England. They have been constructing a roof for the boys' dormitory and repainting some of the exterior wall. Tuesday evening, Megan and Paul joined us, and are volunteers at "Grandsons of Abraham", an orphanage/school in Mombasa, so they have to travel via Matatu every morning at 6:30 to go to work. Paul is from Wales and Megan from Scotland if I'm not mistaken, and they will be here 7 weeks. On Wednesday, Andrew and Julie arrived, and are also from England, though they didn't know each other before they were dropped off at our house together. Julie however, has taken to the motherly role of Andrew quite quickly (she is 30 and he is 19) reminding him to take his Malaria tablets at dinner, making sure he's ready for the Matatu departure in the morning. Everyone is so friendly, and swapping stories about the two orphanages/schools has given ideas to both sets of volunteers. Grandsons of Abraham evidently have an orphanage in Tanzania as well, and have sent Julie and Andrew there from this Wednesday through July 8. I will miss seeing them again before I leave for home, but hopefully everyone will keep in touch still.

Continue reading "New Faces and New Places" »

Posted at 8:20 AM | Permalink | Comments (5)

I will start my post this week with some good news about the Cholera outbreak, from our school at least. The two cases seemed to be our only ones, and they have fully recovered. The older student was even back in my class Monday night, acting as if nothing has ever happened. The current nation-wide report stands at 4000 cases though, and roughly 85 deaths. The evening news continuously reports on the Cholera outbreak, but seems to always been giving the same information: current tallies of deaths and cases, and just that the government "has it under control". On the local level though, there's no sense of which water sources are clean, whether the Cholera is confined to a specific administrative district, or any guidance on what to do if you are feeling ill. Christine has mentioned that such covertness is Kenya's biggest problem with regard to public health. Officials don't give the public enough information to keep them safe from disease, and then the public loses trust in any prevention measures the public health officials suggest. Certainly this balance of sending appropriate messages to the public without causing excessive worry is difficult for all countries, but with Kenya's government already distrusted by its people, managing the flow of public health information is even more sensitive.

Class has taken place all three scheduled times since my last entry. That in itself is an accomplishment. Thursday evening we addressed the molecular-level process of how HIV invades T-cells and compromises your immune system. I had some drawings of the various stages of HIV: not-infected, early infection (weeks), later infection (months), late infection (AIDS). My artistic talent is not so wonderful, and everyone got a kick out of the "body warriors" my stick figures with swords holding antibodies. But, I think the point was well made that the warriors die off, and the virus takes their places in the blood.

Continue reading "Healthy, Happy, and Class is Back in Action" »

Posted at 5:06 AM | Permalink | Comments (4)

From the start of this endeavor, I knew I would learn more during my time in Kenya than I would ever be able to teach to the students at Jambo Jipya. To me, that statement implied that I would understand what education means to these students, be intrigued by their pastimes, and humbled by their daily tasks. Certainly that holds true, but I still envisioned the teaching of any epidemiologic principles coming from me, the lecturer, to the students. Moreover, I expected my project to focus on HIV/AIDS awareness...Mtwapa has decided that perhaps I have selected the wrong infectious disease: there is a Cholera outbreak in the Mombasa area, and the school has had its first cases. I think my field experience has just encountered a new hands-on component.

I arrived at school Sunday afternoon to let the boarders play with the video camera, watch a slide show of their photos on my computer, and just hang out. I saw Anita, Christine's daughter, thinking she had just stopped in after church. No, she informed me that one of the boarders was taken to the hospital earlier in the morning and they weren't sure what had caused him to have such horrible diarrhea. I stayed with the other students for a while, and later went to the hospital with Anita (luckily it's just a few buildings down) to visit the ill child. He looked so weak and spoke it a whisper, coming in and out of consciousness unpredictably. I couldn't believe it was the same student who, less than 24 hours earlier, was jumping up and down with excitement, leading the class in the film-making process. At that point, his diagnosis was Typhoid Fever.

Monday, I went to school around lunchtime to learn that another student had taken ill, and was also at the hospital. Again, the child was a boarder. There was some more waiting, and Anita said that some public health officials had come to the school earlier in the morning, speculating that the local Cholera outbreak was responsible for these children's sicknesses as well. By the afternoon, it seemed that in fact Cholera had been the culprit. Both boys had responded well to rehydration therapy, and were awake and eating. It was definitely a bad few hours for them, but luckily not too severe.

Continue reading "Where is John Snow when you need him?" »

Posted at 4:04 AM | Permalink | Comments (5)

I wish I would have postponed my previous blog just one more day; I ended up in Mombasa on Thursday of last week, and would have been able to post some pictures. However, I hope to make up for it here as Christine’s son finally found a camera charger for me to borrow, and her daughter, Destine and I are back in town to do some basket shopping. So with a little luck from a fast internet connection, some long awaited photos are below.

Back to my purpose here in Kenya though…the project. This past Thursday I was going to teach in the evening, but suffered the technical difficulty of no electricity. So instead, we went a bit longer on Saturday, and it seems that the students respond better in the afternoons on the weekend than the late evening class during the week. First, I spoke with the boys alone for a bit of “sex-ed” and sent the girls to another classroom to work on some posters that we will be using in the video that summarizes all of our lessons. In addition to reviewing the parts of the reproductive system the students have already learned in their science coursework, we discussed why certain parts of the body seem to have more names than others. For example, there is only one word for “elbow” in any given language, and yet the slang terms for “penis” or “breast” seem innumerable. Among other reasons, the boys concluded that people are afraid to flat out talk about sex, and so they try to be cool about their discussions of it, producing new terminology. When we moved to the second half of the session, the boys were sent to make posters, and the girls and I had our discussion. To the same question of body part naming, they brought up the issue of power, and that people often use the derogatory names for private body parts to make you feel bad about yourself. Such negative connotations can lead to lower self-esteem, and in conjunction with lacking defense mechanisms, can create an opportunity for non-consensual sex.

Needless to say, I was impressed with the maturity of both the boys and girls in their discussions. Saturday also gave me a little boost of confidence in the project, that the students understand me, the girls are very capable of talking, and the class itself does discuss meaningful issues. I also think the posters will be a great addition of color and text to the video, and am anxious to get filming. I think the mini-art project also gives them some time to take in the main definitions and discussion points this far in the project as well as a break from the classroom setting. Everyone even stayed after class to continue listening to the iTunes on my computer, and coloring a bit more.

Continue reading "I have a camera charger!" »

Posted at 4:03 AM | Permalink | Comments (6)

Last Wednesday I was finally able to sit down with Christine and plan a schedule for the HIV/AIDS awareness program I came to teach at Jambo Jipya. We settled on Monday and Thursday evenings as well as Saturday afternoons. I think three times per week will be good for me as well as the students. As I likely mentioned before, the students are in class from 8:00am-3:20pm, then they have activities such as going to the field, debate, clubs, etc., at 5pm the day students go home except for Class 8 who have another hour of studies. Tea is taken at 6pm, and then it’s down time until dinner at 8 for the students who board at the school. Since I am working with students in Class 6 through Class 8, that means the earliest we can start in the evening is 6pm, until 7:30 or so. Saturdays I am able to work with them from 2pm through whenever, but before lunch, they also have class. So while there is a lot of material to cover, I also don’t want the students to feel overwhelmed by having to sit in a classroom more than they already do.

Luckily, I had a little bit of help my first night from a teacher at the school as well as Christine’s daughter. They helped me round up the right students after tea time, and class began just after 6pm on Thursday. I spent the first part of the class trying to learn students’ names (I still need to work on that) and doing simple ice breakers like “What is your favorite food?” “What do you like to do in your free time?” etc. I then opened the floor up to questions about me. They could ask anything they wanted, and the most interesting question came from the other teacher in the room. He asked me to explain the US education system as I had said I was 21, and there were students in the room aged 17 or 18, not near going to college let alone a Master’s program. For better or worse, the Kenyan education system is based on exams that you must pass in order to progress through each class. Not everyone starts Kindergarten at age 5, and not everyone goes through one class per year. So the idea that you would get through Class 8 (8th grade) and Secondary school (high school) by age 18 is unlikely.

Introductions also gave me time to get a feel for classroom teaching in Kenya. Students are expected to answer your questions by standing up and restating your question in their answer. So, when I asked the opening discussion question of the evening: “What does being healthy mean to you?” The response always began with a student rising and saying “Being healthy means…” Although at first I thought that type of answering was a bit excessive, it does help the students focus on what I’m asking, and particularly since it is in English, it helps the other students to hear the subject of the question again in case they missed it the first time. As for the information we covered in the first session, we discussed the five different aspects of health: physical health, mental health, social health, emotional health, and spiritual health. Then we all (myself included) set a goal for each aspect to work on during the course.

Continue reading "First Project Update" »

Posted at 4:06 AM | Permalink | Comments (5)

It’s a good thing I got my last post off when I did…I experienced my first power outage of my time in Kenya while we were at the internet café in Mombasa. It became evident as we went to pay our bill that when the electricity goes out; it is more than just an issue of not having lights working. The woman in front of us was irate about either having to pay or not being able to finish her work on the computer, and the owner could do nothing to calm her because he was too busy hoping people would be honest with him about what their time counter on the computer said they owed. The man was huddled with his cell phone as a flashlight over the cash drawer trying to make change for the customers who actually stayed to pay their bills. Now, the man not only having lost out on some money from current patrons no doubt, would be without customers until the electricity went on again. Without a generator (as some wealthy businesses have) the economic livelihood of small businesses depends on the chance of whether they will have electricity, and for how long. Given that small businesses are the foundation of life in Mtwapa and Mombasa alike, it is easy to understand how the “I’ll take life as it comes” mindset surrounds daily interactions.

Which brings me to my project…I was to begin teaching yesterday, Monday May 25. I had expected that relationship-building and gaining a cultural appreciation for Mtwapa before getting into the classroom would be important. Sunday evening, Christine, Keela and I were going to sit and discuss a daily schedule a little further, but Keela became quite sick. So on Monday, instead of being set on getting down to work, Christine requested that Keela and I rest a bit more in the morning, and just visit the kids in the afternoon as Keela is leaving today. Luckily, the curriculum for my project is quite flexible, and I will happily embrace the opportunity to truly take in the experience of Mtwapa when I am not teaching.

What has Mtwapa been like? Amazingly beautiful, incredibly challenging, and increasingly reflective. Let’s begin with the amazingly beautiful part. Every morning I wake up to three roosters crowing (which is actually kind of frustrating because they start sounding around 4am, and trust me the sun doesn’t come up until 6:30) nonetheless, it is the experience of farm-living I never had, and not that different from the trains running across Hennepin Avenue, so to me it’s just a new type of alarm clock. I then proceed to the kitchen where I make myself some tea and breakfast and head up the stairs to a huge, covered porch. With a gentle breeze and a lot of sunlight I sit and read for a bit while palm trees shade the right side and a view of beach apartments and open land are to my left. Mtwapa’s beauty also lies on its shores. On Saturday, we took the kids to the beach and could see the boats along the North Shore of Mombasa with water for miles and not a cloud in the sky. Likewise, at church on Sunday we sat in a building that was no more than a huge shed with plastic chairs and a simple altar up front. The structure itself was unremarkable, but the way in which the windows allow for as much sunlight and air to flow through naturally made it one of the most pleasant indoor environments I had visited yet. Finally, Mtwapa is beautiful in the smiles of the kids when they gulp down their Sunday treats of soda (pop for you Midwesterners), and watch a slideshow of pictures they took on Keela’s camera which she put on her laptop to show them.

Continue reading "I was in Minneapolis a week ago?" »

Posted at 5:54 AM | Permalink | Comments (7)

Good news: I made it to Mwtapa, Kenya! I arrived Wednesday morning, and Keela (American Volunteer and founder of Reason2Smile) and Christine (Host mother who runs Jambo Jipya) met me at the airport with Christine's son-in-law, Jay who drives one of the hundreds of Matatus that dominate the streets, no, correction, one street from Mombasa to Mwtapa. I quickly learned this will be the most comfortably Matatu ride I will have while I'm here as they typically carry 15-20 people, not just me and my luggage.

I was surprised, and most excited that Christine's house has 5 bedrooms, and multiple bathrooms. The toilets may be missing seats, and the water trickles in the sink, and the showers are so cold, but it allows me to stay cool and clean, so no complaints! Wednesday afternoon we went to visit Jambo Jipya, and went to the "field" with the kids once their classes were over. The field is a dirt and semi-grassy patch about the size of a soccer field. However, they walk about 10 minutes each way to the field, and the school rents the plot, so they can only go Monday and Wednesday from 3:30-5:00pm. Plus, there are 300 students, which fills the field quite quickly giving them little space to run and play. Nonetheless, they had a great time, and they the girls taught me the Kenyan equivalent of the hand slapping games we played in elementary school in the US. Christine, Keela, and I took one of Christine's recommended drivers back to the house, enjoyed beans and Kenyan tortillas, and I was ready for bed!

Continue reading "First few days in Mwtapa" »

Posted at 3:42 AM | Permalink | Comments (8)

Good morning Minnesota! I’m getting ready for flight number two on my way to Kenya, and have had a full day of fun in Amsterdam before you probably woke up this morning. Luckily, I can sleep on planes pretty well, and since my seat partner was absent on the plane last night, I had the window AND aisle seat to myself. I don’t think the same will happen on the way to Nairobi, it should be a full flight. Nonetheless, I downed some caffeine before landing this morning, and by noontime was on the bus to Keukenhof.

Keukenhof is an annual tulip festival held in the countryside in Amsterdam. Evidently this was their 60th year, and ironically enough, the festival was themed around New York, and the Statue of Liberty. It was a tough decision figuring out what to do during my 9 hour layover, and museums, and the Anne Frank house were well-recommended to me. However, knowing that I was going to be cooped up again for another flight, I took the opportunity to tour the tulip gardens. I stretched my legs for a good two and a half hours, took the opportunity to drink some extra water, and will be ready for a good night’s sleep to Kenya. Unfortunately, Keukenhof closes in two days. Which I thought would make it prime time for the tulps…quite the opposite. Spring must hit Amsterdam much before Minneapolis, and most of the flowers had already been cut back. That didn’t stop visitors from walking about though. There was a bride and groom getting photos taken, and even when the flowers are absent, the number of sculptures in the gardens out numbers those at the Walker in Minneapolis 10 to 1. Of course, as luck would have it, the rain did come out today, but I was ready with my snazzy lime green jacket  The flowers that were still blooming were magnificent, and the indoor greenhouse smelled so wonderful I wanted to pick a bouquet for the plane ride. (I’ve uploaded a mini-tour of the greenhouse to UTube http://www.youtube.com/user/UMSPH, and quick clip of the HUGE music box that was there.)

All in all, I would say Amsterdam is definitely a place I’d like to visit again in the future, and I am so thankful I had the opportunity to walk and tire my legs out for the evening. I also petted a Newfoundland that was twice my size and the gentlest dog ever. So basically, my day was complete. As far as the Amsterdam airport goes, it was so simple to exit and re-enter, I stored my backpack and miscellaneous items in a locker while I was gone, and hop a bus directly to Keukenhof and back. It is definitely a user-friendly airport, and some of the nicest information staff anywhere.

I am all smiles (as per the photos below) and now with a clean shirt, socks, and some extra deodorant…I’m ready for Nairobi!

Posted at 11:17 AM | Permalink | Comments (5)

The clock is ticking on my one hour internet access...as well as until I board the plane for Amsterdam. This marks day one of three for travel to Mwtapa, Kenya, and this next hour will likely be the calmest of the past several days. I have probably made more "Target Runs" in the past 48 hours than I have since the start of the school year, and my bag was packed, unpacked, and repacked at least 3 times. I visited my parents in Alabama, got through a few finals, saw my roommates off for the summer, and attended the SPH Gala. Finally, the bag is checked, I had a decent meal at the airport before security, and the best news...there is actually a plane at the gate! (Always a good sign when you're getting ready for departure.)

For those of you who may be reading this who don't know me, (and for those of you who I haven't kept in touch with incredibly well) I am taking off tonight for my six-week field experience at Jambo Jipya The Future Child School in Mwtapa, Kenya. (http://www.reason2smile.org) I will be teaching and HIV/AIDS awareness and youth empowerment program to some of the older "boarders" at the school, and gaining a perspective of health and education on the other side of the world. I have just finished my first year of my MPH-Epidemiology program, and while this field experience may appear more in line with our division counterpart, Community Health, the concentration of the experience is on strengthening me as a public health professional. Understanding other cultures, exploring various approaches to health care, and simply gaining exposure to another way of life will be critical if my career leads me to global health issues.

With one hour to go until wheels are up in the air, I wanted to take a few moments to think about my hopes and concerns of this trip. Certainly, I trust that this will be a valuable academic experience and relevant to my future interests in epidemiology on a global scale. It is also a chance for me to truly travel independently. I have been abroad numerous times in the past, but Africa is one continent I have yet to experience. No parents, no teachers, no friends are travellng with me...it's going to be a long plane ride, but I am anxiously awaiting the smiles of the kids when I arrive at Jambo Jipya. Finally, I hope that my time has come to give back, in an arena where I may be of service. Every person that I know who has volunteered abroad says that the experience brought an indescribable perspective to their worldview. I do not expect that working with the youth at Jambo Jipya will fundamentally change me as a person, but I do believe it will challenge me to consider life's decisions, big and small, in a new context.

With regard to my concerns, they are simply that. I am not fearful about my time in Kenya, rather, I question how I will deal with a different way of life. In Minneapolis, I don't have to think about when I want to run, ride my bike to the grocery store, make dinner, or go downtown. I will now be dependent not only on another family's schedule, but in a setting where I have to find my way around again...and do so safely. Along those lines, I am by no means a picky eater, but I cannot escape my weak stomach. I am concerned that I will "slip up" and drink some bad water, or eat some washed lettuce. However, I am optimistic that the smiles on the kid's faces, along with the fact that my host "mother" is a nurse by profession, that those concerns will be set aside, and I can concentrate on making my hopes a reality.

I invite you to write your thoughts, hopes, questions, etc. here on the blog. I should have access to it a few times a week. I'll be checking in from Amsterdam tomorrow! Sleep tight!

Posted at 7:29 PM | Permalink | Comments (2)