Orphans & Vulnerable Children

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.

The Mara

These pictures are long overdue as well. A few weeks ago I went on safari to the Maasai Mara, which is one of Africa's greatest wildlife reserves. It is an amazingly beautiful & serene place. There is no place on earth like it. So I went with two friends from George Washington who have been doing their fellowships in Uganda (not too far from me). They came along with some of their co-workers in Uganda who were from Canada. We had an absolutely wonderful. We stayed at this camp called Sarova. We were treated like kings. Sarova is a permanent tent camp but "tent" and "camp" hardly capture what it was like. It was definitely one of the nicest places I have ever stayed. So we saw almost all of the typical animals to be spotted in the Mara. We saw almost all of the big five. The big five include the lion, elephant, buffalo, black rhino & leopard. We saw the first 3 up close and we think a leopard from a far. We did not see the black rhino which is an endangered species. Below are a few of the pictures of the scenery & the animals. If you ever find yourself in Kenya, the Maasai Mara has to be on the top of the list of places to see.

Self-portrait on the long road journey to the Mara.

The Sarova. Wonderful place to stay.

Our "tent" at Sarova - there is a permanent bathroom on the backside of the tent, hardwood floors inside, etc.

The bedroom in our tent. Very comfy bed.

One of my favorite animals - giraffe!

The most magnificent creature in all of the Mara (in my opinion), the lionness.

The king of the jungle

Baboon getting close to our car. One was eating some sort of paper in the road.

We saw lots of zebra.

A bit fuzzy but you can see the rain coming from the cloud ahead.

Standing outside of our safari van in the sun. Akin told me not to get out of the van at any time in the wild but obviously I didn't listen. :)

This is the border with Tanzania. T for Tanzania & K for Kenya. So really, I have now been to Tanzania too.

The whole group standing on the border

Here are the buffalo.

A large family of elephants crossing the road by us.

The elephants decided to play, drink & bathe in the water hole.

Lots of impalas.

The view of the beautiful African plain. Had to capture the acacia trees again.

At long last, I have been able to upload a few pictures from my trip a few weeks ago to Mombasa. For those of you who don't know, Mombasa is on the coast of South-eastern Kenya, on the Indian Ocean. Actually the city of Mombasa is an island. From the mainland you have to go over a bride (in the north) or take a ferry (in the south) to get to & from the city. The first full day I spent at the coast, I went to Diani, which is a lovely quiet beach, south of Mombasa on the mainland. I relaxed & ate at a resort called Nomad. It didn't take long for me to burn in the very hot & intense sun. I had sunscreen on & within less than 2 hours of direct sunlight had a burn on my shoulders & back. That was over 3 weeks ago and my skin is still peeling from the burn (sorry to be gross). The next two days, I spent in the northern part of Mombasa near my hotel & downtown. I have a few pictures from driving around downtown. Mombasa has a very different feel from any other place I have been in Kenya. Unlike the rest of Kenya (except maybe the north east portions), Mombasa is largely Muslim. There is a lot of Islamic influence, even in the architecture of the city. I have never been to any part of North Africa but Mombasa feels like what it would be like to be in the predominantly Muslim areas of North Africa. I really enjoyed my time at the coast. It was a wonderful break & time of relaxation. I also had some of the best fish I have ever tasted! If you ever find yourself in Kenya, I highly recommend going to Mombasa. It is quite a unique experience. But be prepared to be very hot! I have never been hotter in my life. It is not only hot with intense sun, but very very humid. Wearning skirts is a must for ladies (shorts really are not appropriate, especially with the strong Muslim influence). Mombasa is also a great place to buy the famous kongas. These are large pieces of African cloth that are usually brightly designed and have a small saying on the bottom of them in Swahili. You have to be careful when buying a konga because sometimes the saying can be quite insulting even if the fabric is beautiful. Apparently it is popular to use kongas to express oneself to others around you, thus, if you are having an argument with your neighbor you would buy a konga with an insulting statement on it. I was quite amused by this. The konga is used in many ways. Many women have entire outfits out of matching kongas or the other popular use is for carrying babies. They wrap little children in them on their backs & tie it in the front. My favorite way to wear my konga is as a wrap over my bathing suit. I am the first person I have seen to do this though.

The beautiful & warm Indian ocean from my beach day at Nomad Resort in Diani.

A view of Nomad Resort from the beach.

Having lunch at the restaurant at Nomad, it was quite picturesque with the blue ocean, sailboats, and open terrace with billowing white curtains.

Self-portrait on the beach. Note - I had already put my shirt back on because I was getting so burnt.

One of my favorite pictures. This is a first for me - camels on the beach. You definitely don't see camels on the beaches in the US!

This was taken at my hotel. This was the private hotel walkway to the beach, lined with palm trees. And yet, upon arriving at the beach, I expected to find a peaceful retreat but found that the beach was lined with Kenyans selling their souvenirs to all the tourists. You couldn't set a toe on the sand without being haggled by them. So eventually I retreated back to the pool.

Here is the pool at my hotel. Quiet & peaceful.

This is the fish I had at a small road-side restaurant that John Kisamwa took me to. It was some of the best fish I have ever had! I have learned to really appreciate eating fish on the bones. I haven't yet been able to bring myself to eat the head though.

A view of Mombasa from the car. You can see the Mosque in the middle of the picture, it appears to be almost jutting out into the road.

Another busy street in downtown Mombasa. Notice how the architecture of the buildings has an Arabic feel.

Here are the famous tusks that line the road coming into Mombasa.

The latest

So for a few days I have been trying to upload some pictures to the blog from some of my recent travels. Unfortunately the internet connection has been going in and out and is not currently fast enough for me to upload pictures. This is so typical of the state of living here in Kenya. Often things here don't work, things that we take for granted everyday at home. I can say that after almost 9 weeks of dealing with these little things (like electricity, internet, etc) I have come to have low expectations. I'm not surprised when things don't work and yet, it still frustrates me. Often my work has been put on hold because I can't send emails to communicate with people at GW or I can't get online to do research. But despite all the little hang-ups, I have managed to finish the big project that I have been working on since I got here. I was designing a research study for the program that I have been working under. I handed it in yesterday morning so that my preceptor can submit is for approval before Moi University's ethics committee. It does feel good to have accomplished this project and yet, looking back I feel like I should have been able to accomplish more during my time here. There are a number of small projects that I will be working on before I leave in a few weeks. I now definitely have a better understanding of why it takes so long for things to be accomplished in developing countries. There are many challenges, one being the lack of sufficient infrastructure and advanced technology.
So I wanted to include pictures of Mombasa or the Maasai Mara where I went last weekend but alas, the internet will not allow me to at this time.

On the road to Nairobi

Over a week ago, I decided to take a short break and do some traveling in Kenya. I left Eldoret on a Friday to take the North Rift Shuttle to Nairobi, which takes approximately 6 hrs. I ended up traveling with two other students living at IU House, Kareem & Phil. Then I stayed in Nairobi for the weekend with the Njoroge family, enjoying some of the sights of Nairobi. From there I left on Sunday afternoon to go to Mombasa on the coast. I again, took a bus with one of the Congress pastors to Mombasa, this time taking 8 or so hours. It was a long dusty ride but I greatly enjoyed seeing the countryside of Kenya. Today I have posted some of the pictures from the shuttle ride from Eldoret to Nairobi. We were traveling through a good portion of the Rift Valley and much of the landscape was very green & lush. We also encountered heavy rain here and there. At one point, closer to Nairobi, we saw zebras & baboons on the side of the road. I will be sure to post more pictures of the trip to Mombasa soon.

Myself & Kareem, sitting in the North Rift Shuttle before leaving Eldoret. Phil was standing outside, watching our bags in the trunk so that they would not disappear.

The view of the bustling town of Eldoret from inside the shuttle.

This is a common sight in the country - donkeys carrying something on their backs. Often you will also see donkeys pulling small carts. As well, you can see the beautiful Rift Valley in the background.

This is one of my favorite scenes - the fields of maize everywhere. I have come to enjoy the roasted maize that you can buy on the street vendors all over town.

This is also a common sight, especially in the area around Eldoret. This is a small village and in the middle is an IDP camp. IDP camps (Internally Displaced People) are all over the place since the post-election violence that this area encountered back in January. There are still so many people who don't have homes to go back to (there was a lot of rioting & burning of homes & businesses) or they don't feel safe to stay in their homes. So often, IDP camps are set up near their homes so that people can go back in the daytime to farm the land and at night they return to stay at the camp.

Another view of the IDP camp with the white tents.

This was taken close to Navasha, which is closer to Nairobi. I love the trees in this picture, acacia trees. But also, in the background are greenhouses. So many of the world's cut flowers are grown here in Kenya, especially roses. They have the most beautiful flowers. However, one of my colleagues went to visit the greenhouses & told us about the atrocious accomodations for greenhouse workers.

A grove of acacia trees, so beautiful.