Orphans & Vulnerable Children (or OVC as it is often known in the public health world) is a branch of the AMPATH program. Not only that, but the topic of orphans & vulnerable children is important in the developing world, especially countries like Kenya where HIV/AIDS has killed so many people. You find many orphans & vulnerable children in this country, so many people have been affected by HIV in so many ways. So last week I spent the day with the co-director of the OVC program, a woman named Elizabeth. She goes out on field visits to people's homes a few times a week with her social workers. She will often take students from the IU program to experience the opportunity to go into the rural home setting & to understand the OVC program better. Last week I go to go out with her to two homes in the Turbo area which is about 45 minutes outside of Eldoret. We first went to the AMPATH clinic in Turbo to meet with the 2 social workers who would be going out with us. The social workers decide what families need to be visited, often for many reasons. Elizabeth goes to provide transportation for everyone & to give support on the ground to the social workers. The first home we went to was far from the Turbo clinic, at least 30-40 minutes farther into the rural area. We had trouble locating the house at first (there are no street names or addresses, usually a landmark is used like a river, etc) and ended up on another man's property. This guy was so excited to see 3 mzungus (white people) and 2 other kenyans pulling into his house. He kept insisting that we stay & take tea at his house as we now were "his guests". But we asking him to allow us to leave because of time we needed to find the family we had come to see. Eventually he relented & showed us where the family lived we were looking for. Of course, he insisted on riding in the packed car with us to their house. So we piled in, some on laps to let him show us. Finally we arrived at the right home & found the family we were looking for. We had come to this home at the edge of the Turbo catchment area to see about 2 orphans who were HIV+ patients at the clinic but hadn't come for their recent visits. The young children (they looked about 7 & 3) were living with their grandparents who also had numerous other older children & grandchildren living with them on their small 1 acre plot of land. None of the children were working & the grandfather was doing a little farming of maize on his small plot. They said the children had missed their appointments due to the lack of transportation money. However, when the children miss their appointments, they are not only missing getting their HIV medication but also the food that is provided by the program for their family. Many of the OVC families rely heavily on the food distribution that is provided. It was hard to think about how a family of this size was having trouble finding a few hundred shillings (about a few dollars) for transportation when they would be losing thousands of shillings worth of food. It is a sad situation. The grandfather seemed to overwhelmed & embarrassed that he could not provide adequately for his family.
The second house we went to was a bit less depressing. We, again, had a bit of trouble finding the home (which seems to be the norm). So we went driving out into the fields on dirt roads with deep crevices. Eventually it was impassible by car so we parked & walked the rest of the way, through people's yards & across fields. We were going to see a boy of about 8, named Moses, who was living with his grandparents. This is one of the most common things to see with orphans of HIV. So many live with their grandparents. So this boy's grandmother greeted us. She was so excited to have visitors (to say the least). She greeted us all & spoke very good English. She was a sweet woman and was clearly taking very good care of her grandson. She insisted that we all stay for 2 days and she would show us around. We told her this was impossible but thanked her for the very kind gesture. She was one of my favorite people that I have met here yet. She was a good farmer & had 3 acres of land where she grew maize. The picture below was taken outside of one of the neighbor's home with everyone.
From left: Maggie - one of the social workers, myself, aunt of Moses, Moses in front, Grandma of Moses (in orange dress), Jane - another student, Caroline - other social worker.
So I also wanted to include a few pictures of some of the other children I have come to love here. Sarah Ellen Mamlin (wife of Dr. Mamlin, director of AMPATH) has started a children's center that is attached to the hospital's pediatric wards. I have spent a good deal of time there, playing with the kids & feeding some of the babies. So the center opens from 9am-4pm every day and has workers who care for the children. There are usually about 8-15 abandoned babies/toddlers who stay in the wards at night & are cared for by the center's staff during the day. Right now there are about 8 or so children. Eventually the children who are abandoned go to a childrens home to stay permanently. Right now one of the children is this little girl named Joyce who is somewhere around a year old but weighs only about 4 kgs, that is about 9lbs. She is very under-nourished for her age. She was born with a cleft lip & palate and has a hard time eating. We have gotten her eating well with a haberman nipple (NICU nurses will understand) and are trying to get the staff to just give her formula with wheat cereal in order to thicken the feeds & provide extra calories for her to grow. They were giving her porridge and chai with bread before - not enough calories & black tea isn't a good idea to give small children. We also recently learned that Joyce has a large VSD (ventricular septal defect, a heart defect in the wall between the left & right ventricle). She will need major surgery to fix both of these defects. Joyce is a little bundle of joy. She loves to be held & played with and is babbling a lot. I have taught her how to blow kisses which is adorable. Below are a few pictures of her. I have also become quite fond of a newborn who was abandoned last week. The story is that she came into the hospital on the day of birth & was left by her mother. She is absolutely adorable! She looks to be about 2.5 - 3kgs to me. The staff have named her Gerrilyn. I am trying to keep the staff from putting 3 pairs of clothes & 3 blankets on her at one time. Here are a few pictures from the Center.
Me & Gerrilyn
Another pic with Gerrilyn
Isn't she adorable! I think she looks bi-racial. She doesn't look like all the other Kenyan babies, she has light skin & straightish hair.
Crystal feeding Joyce her morning bottle.
Don (Crystal's husband) playing with one of the older boys, Scott.
Scott & Don laughing together.
Crystal giving Joyce some tummy-time, trying to get her to crawl a bit. She is quite behind developmentally with her gross & fine motor skills.
Another shot of Joyce playing on the floor.
Here are the babies, lying in their shelves, wrapped in blankets - their charts are underneath.
A few more shelved babies on the next wall.
Two naked babies with heplocks. I think they were recent newborns & were being more closely observed which is why they are not bundled. 
A closer look at the bundled babies lying in their shelves.
Below the shelves are the wall heaters to keep the room hot!
Right outside of the main room there is another smaller room they use for isolation. They put babies who have come from home here as well as any septic babies. The box in the left corner is their phototherapy box with lights. 
