Progress at Last?

Dear Everyone,Things are starting to show some progress on the project finally. After waiting for a month and a half I was finally able to meet with the District AIDS and Sexually Transmitted Infections Control Officer (DASCO) yesterday morning. It was a typical meeting with an appointed bureaucrat in Kenya, lots of dodging questions and evasiveness and little to no answers. The good thing came out of the meeting was that I was able to get a copy of the “Instruction guide for VCT site registration, annual licensing and accreditation.” There was only one copy of the document for the entire district so I had to go down the street from the district hospital to a shopping center to make a photocopy of it. The document provides the criteria for which the VCT shall be evaluated for registration. This is great aside from that it doesn’t elaborate nor explain where things such as the national VCT guidelines may be found and acquired for being displayed. When I inquired from the DASCO how to acquire such things he dodged to the best of his ability, attempting to hide that he didn’t know. This was especially frustrating when I asked for supplies and knowledge that all other VCT’s I had visited said they acquired from their DASCO. I tried to schedule an inspection for registration with him for as soon as possible knowing how ‘Kenyan time’ runs, and he wouldn’t set a date with me unfortunately. He said they’d be able to come as soon as we had the clinic ready, but it might take them two weeks after date before they came. With the guidelines in hand I am now attempting to acquire all the supplies necessary to ensure that our clinic shall be ready for inspection and registration as soon as possible. It feels great to finally be accomplishing something.Aside from the monotonous boredom of waiting for responses and information from the government I managed to a few little excursions. Two Sundays back when I was planning on going to Kakamega I ended up climbing a local mountain, Mount San’galo. It was getting to late in the morning that day to head to Kakamega and be able to truly appreciate it so we headed to Bungoma instead. While there Ellison and I decided to head to Mount San’galo, while Rhea and Sean headed back to the farm because they weren’t feeling so well. Riding a matatau to the village San’galo we could see the looming rock outcropping rising out of the fields of maize and cane as the first drops of started to fall. We got dropped off about half a mile from the mountain and began to walk down narrow footpaths cutting through fields of crops to gatherings of mud huts and into claustrophobics passages in the sugar cane before arriving at the base. At this point the afternoon rains had already come and proceeded to drench us for the rest of the journey up the mountain. It was exhilarating climbing up mountain as we walked, jumped, shimmied our way up amongst the rocks. At one point we even had to squeeze through a gap just large enough for our bodies without a bag as we braced between to two walls of rock on either side to support us pulling ourselves through and up. After this squeeze we arrived at high level area which led us through a cave formed from one massive boulder balancing on another which we had to go through to continue on. Once we got as high we could without climbing gear to scale the sheer stone pillar that went up another hundred feet, we were granted with a beautiful panorama looking across the African farmland surrounding us. It felt like we were at pride rock in the Lion King with a large table top like boulder balancing horizontal stretching out before us. During the climb it finally felt like I was in Africa, that I was out in the wilderness exploring not just sitting around at the farm.Last Friday night I went to a Hindu temple for the first time. Krishna had been invited by some members of the local Indian population to bring some volunteers over for a festival that began that day. I was given a tour of the temple which consisted of a large main room and two adjacent areas. In the main room walls were covered with pictures of the Hindu gods and prophets and an altar was in the middle of the floor with people dancing about and a stage with a band in the rear. On the right side there were shrines to various Hindu gods and prophets along with an area for burnt offerings, while the left side housed a kitchen attached to the main room. When I arrived people were dancing around the altar in a rhythmic pattern I had no chance of picking up. I ended up talking along with Krishna and Brent, a Peace Corps volunteer, to various Indian gentlemen there. It was interesting talking about the project with them because they all said that it was taking so long for our project because we had not bribed any of the official and that would move things along. Even Brent talked of having to bribe people to get his Peace Corps project done. It’s frustrating that everyone here just accepts corruption to be normal practice and supports it. At some point this round dancing ended and we had dinner which consisted of some savoury fried potato balls along with a spicy chutney and a tamarind sauce. After dinner was another round of dancing. This time it included sticks which you hit in a pattern while dancing with a partner. I was able to get this down and participate. There was an elderly Indian on the side who encouraged us on, telling us to be more exaggerated pick up the pace of the dance to the beat. It was all around a fun evening and I may go back sometime this week with Krishna once he’s back from his trip to Rwanda because it’s a nine day festival.Hopefully things will get moving along a bit quicker on the project now, and we’ll be able to have the VCT up and running before we leave.
Josh

A Month in Kenya

Dear everyone,A month in Kenya now and I’m pretty well accustomed to life here now. I’ve gotten used to pumping water by hand for the cold water showers, the frustratingly lackadaisical concept of ‘African Time,’ and the staples of the Kenyan diet Ugali and sukuma wiki. On the project front we’ve continued to be unsuccessful with meeting the District Minister of Health. We’ve managed to make some progress though with Ruben having made contact with him. This week we were able to have a preliminary inspection of the clinic building, and shall hopefully have a preliminary VCT inspection soon. We interviewed two potential counselors this on Wednesday as well. One of them looks promising. It’s getting frustrating waiting on the local Ministry of Health for any substantial progress to be made on the project. We’ve had a bit of scare this past week concerning the finances of the project. Luckily we were able to review our finances, and hopefully things are resolved now.I was able to make my first leisurely trip out to explore the sites of Western Kenya two weekends ago. Sunday morning Ellision, Stephanie, Vince and I set out to see Webuye Falls. Departing ICODEI we went up to the road in Kabula to catch a matatau, only to have to wait about an hour before we could catch a ride. Once we got to Webuye we decided to pick up some food, ended up at the shadiest restaurant I’ve ever eaten at. The place was on the side of the road next to a welding shop, with a tank connected to the gutters to supply water to wash your hands with. Once inside we decided to order to discover that the posted menu on the wall really wasn’t useful. We ordered two of what the guy across from us was eating, since it appeared to be the only thing available. It ended up being some fried mystery meat looking like gristle with a very odd and pungent flavor, along with ugali and sukuma wiki. After just a few bites we decided to move on a get a ride to the falls. This ended up being a lot more frustrating task than we expected. Initially we arranged for a car to come and take us up to the falls for Ksh300, only for the driver to try to charge us 500 after he got gas. We ended up arguing with the guy for a few minutes before getting fed up and walking away from the car to try to get another ride to falls. Riding in the back of a pickup the surging torrents of muddy water cascading down came into view as we winded our way down a hillside to the viewing area. Once we were at the falls we proceeded to explore the surrounding area climbing up the stones that offered natural viewing points before going up the path alongside the falls. Atop the falls we were able to walk down to the water’s edge, where Ellison decided to take a plunge in some of the calmer waters. A choice we were later informed wasn’t so bright or hygienic even by African standards. While there the evening thunderstorms decided to surprise us coming in the mid afternoon to provide us with a drenched hour walk back to town to catch a matatau back. Hopefully this tomorrow I shall be heading down to Kakamega to the national park there. It is one of the last stands of equatorial rainforest in Western Africa, with unique wildlife more similar to that of the forest of the interior like the DRC than Kenya.Two weeks ago I had my first real experience with African medical care. Three Fridays back I had been helping the mobile clinic as pharmacist in Kitale when I got a headache. The headache persisted over the weekend with the development of fatigue and lethargy along with general malaise. I figured, and still do, that I probably was just exhausted from lack of sleep along with general life over here and possibly a cold when Ruben said he believed I probably had malaria. He said that based on his experience with international volunteers over eight years that I should go get a malaria test. That evening there was a bit of a joking witch hunt that I was sick with malaria with the other volunteers. The next morning when I was loading out to work with the mobile clinic I was suddenly really nauseous, and decided to stay behind. I returned to bed to sleep away the morning, still feeling like I just had a slight cold. That next day I started feeling feverish, so resolved to finally go get a malaria test.I caught a matatau into Bungoma and walked the mile to the district hospital. The hospital was about a 2 acre compound scattered with one story concrete and mud building and outdoor waiting areas. Not knowing what to do, I asked a man in business attire coming out of an office where I could get a malaria test. Without a word he led me down a hallway to room where two doctors and a woman were sitting around a table. They immediately moved the women to the side of room and told me to take a seat. When I asked if I had interrupted and offered to wait they said that they were done with the women. Meeting with the doctor was bit of joke. I asked for a malaria test, and then proceeded to describe my symptoms. He then asked if I was competent to take four pills twice a day for three days, then wrote me a prescription for AL and told me to pick it up in the morning as the pharmacy was already closed for the day. When I asked for a test, he simply waved me off and sent me on my way. I now understood why Ruben avoids going to the district hospital versus the private one in Mumias. The whole experience seemed pretty shady to me, and I’m unsure if being a muzungu got that treatment or not. None the less, a few days later I got better and felt as good as one can feel living in rural Africa. I still feel that the likely hood it was malaria is slim, so hopefully if it was the strain that doesn’t have a life cycle in the liver so I don’t have flair ups later in life.African time has ensued to provide me overly ample amounts of free time, frustratingly so by the lack of progress on the project. Luckily I’ve been able to find some ways to occupy my time while I wait for word from the Ministry of Health. There’s a small library at the school in the ICODEI compound with books donated by past volunteers and Indiana University. Initially I read Ishmael, which was a philosophical argument about humanity’s obligation and role to its environment set in a narrative. Since finishing that I’ve taken to the old James Bond novels by Ian Flemming, having never read one before. They’ve been a nice easy and wonderful distraction from the frustrations of life out here. I was a bit surprised how much different they are than the movies as I remembered them. Along with reading I’ve been helping Ellison with his project. He’s working to create a small factory to produce ceramic water filters and more efficient stoves. His project has been an outlet to do some physical labor building the structures for the factory. On Thursday we lit up the kiln for a test run but unfortunately were only able to get it up 850 degrees Fahrenheit, instead of the 1600 that he needed. That’s about all for now. Hopefully I’ll get computer and internet access more often so I can keep you all updated. Josh

A Month in Kenya

Dear everyone,A month in Kenya now and I’m pretty well accustomed to life here now. I’ve gotten used to pumping water by hand for the cold water showers, the frustratingly lackadaisical concept of ‘African Time,’ and the staples of the Kenyan diet Ugali and sukuma wiki. On the project front we’ve continued to be unsuccessful with meeting the District Minister of Health. We’ve managed to make some progress though with Ruben having made contact with him. This week we were able to have a preliminary inspection of the clinic building, and shall hopefully have a preliminary VCT inspection soon. We interviewed two potential counselors this on Wednesday as well. One of them looks promising. It’s getting frustrating waiting on the local Ministry of Health for any substantial progress to be made on the project. We’ve had a bit of scare this past week concerning the finances of the project. Luckily we were able to review our finances, and hopefully things are resolved now.I was able to make my first leisurely trip out to explore the sites of Western Kenya two weekends ago. Sunday morning Ellision, Stephanie, Vince and I set out to see Webuye Falls. Departing ICODEI we went up to the road in Kabula to catch a matatau, only to have to wait about an hour before we could catch a ride. Once we got to Webuye we decided to pick up some food, ended up at the shadiest restaurant I’ve ever eaten at. The place was on the side of the road next to a welding shop, with a tank connected to the gutters to supply water to wash your hands with. Once inside we decided to order to discover that the posted menu on the wall really wasn’t useful. We ordered two of what the guy across from us was eating, since it appeared to be the only thing available. It ended up being some fried mystery meat looking like gristle with a very odd and pungent flavor, along with ugali and sukuma wiki. After just a few bites we decided to move on a get a ride to the falls. This ended up being a lot more frustrating task than we expected. Initially we arranged for a car to come and take us up to the falls for Ksh300, only for the driver to try to charge us 500 after he got gas. We ended up arguing with the guy for a few minutes before getting fed up and walking away from the car to try to get another ride to falls. Riding in the back of a pickup the surging torrents of muddy water cascading down came into view as we winded our way down a hillside to the viewing area. Once we were at the falls we proceeded to explore the surrounding area climbing up the stones that offered natural viewing points before going up the path alongside the falls. Atop the falls we were able to walk down to the water’s edge, where Ellison decided to take a plunge in some of the calmer waters. A choice we were later informed wasn’t so bright or hygienic even by African standards. While there the evening thunderstorms decided to surprise us coming in the mid afternoon to provide us with a drenched hour walk back to town to catch a matatau back. Hopefully this tomorrow I shall be heading down to Kakamega to the national park there. It is one of the last stands of equatorial rainforest in Western Africa, with unique wildlife more similar to that of the forest of the interior like the DRC than Kenya.Two weeks ago I had my first real experience with African medical care. Three Fridays back I had been helping the mobile clinic as pharmacist in Kitale when I got a headache. The headache persisted over the weekend with the development of fatigue and lethargy along with general malaise. I figured, and still do, that I probably was just exhausted from lack of sleep along with general life over here and possibly a cold when Ruben said he believed I probably had malaria. He said that based on his experience with international volunteers over eight years that I should go get a malaria test. That evening there was a bit of a joking witch hunt that I was sick with malaria with the other volunteers. The next morning when I was loading out to work with the mobile clinic I was suddenly really nauseous, and decided to stay behind. I returned to bed to sleep away the morning, still feeling like I just had a slight cold. That next day I started feeling feverish, so resolved to finally go get a malaria test.I caught a matatau into Bungoma and walked the mile to the district hospital. The hospital was about a 2 acre compound scattered with one story concrete and mud building and outdoor waiting areas. Not knowing what to do, I asked a man in business attire coming out of an office where I could get a malaria test. Without a word he led me down a hallway to room where two doctors and a woman were sitting around a table. They immediately moved the women to the side of room and told me to take a seat. When I asked if I had interrupted and offered to wait they said that they were done with the women. Meeting with the doctor was bit of joke. I asked for a malaria test, and then proceeded to describe my symptoms. He then asked if I was competent to take four pills twice a day for three days, then wrote me a prescription for AL and told me to pick it up in the morning as the pharmacy was already closed for the day. When I asked for a test, he simply waved me off and sent me on my way. I now understood why Ruben avoids going to the district hospital versus the private one in Mumias. The whole experience seemed pretty shady to me, and I’m unsure if being a muzungu got that treatment or not. None the less, a few days later I got better and felt as good as one can feel living in rural Africa. I still feel that the likely hood it was malaria is slim, so hopefully if it was the strain that doesn’t have a life cycle in the liver so I don’t have flair ups later in life.African time has ensued to provide me overly ample amounts of free time, frustratingly so by the lack of progress on the project. Luckily I’ve been able to find some ways to occupy my time while I wait for word from the Ministry of Health. There’s a small library at the school in the ICODEI compound with books donated by past volunteers and Indiana University. Initially I read Ishmael, which was a philosophical argument about humanity’s obligation and role to its environment set in a narrative. Since finishing that I’ve taken to the old James Bond novels by Ian Flemming, having never read one before. They’ve been a nice easy and wonderful distraction from the frustrations of life out here. I was a bit surprised how much different they are than the movies as I remembered them. Along with reading I’ve been helping Ellison with his project. He’s working to create a small factory to produce ceramic water filters and more efficient stoves. His project has been an outlet to do some physical labor building the structures for the factory. On Thursday we lit up the kiln for a test run but unfortunately were only able to get it up 850 degrees Fahrenheit, instead of the 1600 that he needed. That’s about all for now. Hopefully I’ll get computer and internet access more often so I can keep you all updated. Josh

First Week in Kenya

One week into Africa (now a nearly two) and what a week it has been. Over the course of the week I’ve turned twenty-one and drank an avocado soda, seen another volunteer go hysterical from malaria, met with an HIV positive support group in the middle of nowhere in Africa, seen some pretty nasty illnesses while going out with the mobile clinic, served as a pharmacists, and gotten lost then run out of gas at 10pm in rural Kenya to push it uphill until we got more fuel.On Saturday, the eighth, I survived the exhausting ten-hour bus ride from Nairobi to Bungoma. Along the way I became intimate with the infamous Kenyan roadways experiencing: suffocatingly thick dust blocking view of the vehicle ten meters in front, treacherous Cliffside curves, and numerous potholes. The scenery was breathtaking however. We rose out of the lowland area of Nairobi to cradle one of the vast troughs of the Rift Valley, looking out over many national parks and game reserves before ascending up ascending up the up to the Western Highlands through the equatorial forests. Unfortunately I haven’t seen much for exotic African wildlife except for the occasional farmed herds of Zebra along the roadside.The ICODEI compound is more impressive than I was expecting, even possessing western style toilets. The huts we live in have solid concrete slabs and with two sets of bunk beds and a dresser, table and some chairs. Meals are served in the family house in their living room, where TV and charging of electronics happens in the evening when the generator runs. There is a friendly group of international volunteers that have been great getting us acquainted with life in Kenya and how ICODEI runs. The compound is a farm yard of sorts with roaming chickens and a dog with fresh litter puppies that chase her about. Across from the house compound is a primary school and health clinic that ICODEI run.We’ve been able to make great progress on the VCT project so far. Last week we met with a VCT counselor Elizabeth whom it sounds is essentially already hired for project. She has been working in Nairobi as a counselor at an NGO run VCT for the past few years, and wants to move back to the Bungoma area where she grew up. She comes with a lot of experience and information which should prove invaluable in helping get the VCT up and running effectively. Last Wednesday we visited an integrated VCT at the Catholic run hospital in Mumias. The visit offered us a wealth of information on the process to start up and run an effective VCT along with an offer to help us with if ever needed. Here we learned for the first time that we shall need two counselors rather than just one in order to get accreditation, so we’re having to figure out how to raise additional funds for such a counselor. On Thursday we were able to meet with two representatives of an HIV-positive support group that had formed in extremely rural and isolated area. There twenty-two HIV-positive individuals had banded together to support and help each other on a bi-monthly basis, rather than just succumb to the fear the plagues the society here. Meeting with the group highlighted that we must offer more than just informing people of their status but to offer them methods to cope to with being positive or being negative and continuing on with their lives. A message reiterated often when I discuss the project with locals. I feel that as part of the project we should attempt to form a network of new and existing support groups to help improve the quality of life of those found to be positive.Friday Krishna and I split up. He went to AMPATH in Webuye while I went out with the mobile clinic to Kitale where I was supposed to meet with another HIV positive group. Krishna was able to make great strides learning much from AMPATH along with acquiring a copy of the government guidelines for VCT clinics. I on the other had got to go one quite an adventure with our driver getting lost multiple times on the muddy ruts of the Kitale countryside, where after about 4 hours we finally found the school we were met to visit at about 1:30pm. No HIV positive group was to be found, but I was kept busy all afternoon working as a pharmacist dispensing medications and learning much from Amos our pharmacists in the Kitale region. The trip back was quite precarious with us not leaving until around 7pm and being on the little dirt roads after dark dodging boda-bodas (bicycle taxis). Once we finally got to the main road we went to gas station to find it closed so we pulled up to a little bar where our driver was able to acquire a one liter water bottle of some fuel or another that was supposed to the next gas station. Needless to say we didn’t make it that far and the pleasure of pushing our vehicle uphill for about 20 minutes on the utter darkness of the Kenyan countryside before somebody was kind enough to pull over give us enough fuel to get us to the fuel station a few miles up. It was about 10:30 before we finally got back to ICODEI.Krishna and I have just returned from a two day trip to Kendu Bay and Kisumu on Lake Victoria. Over the course of the trip we were able to visit an integrated VCT and a HIV comprehensive care center at a hospital, a standalone VCT center, along with Liverpool VCT counseling and training center. It was a very informative trip staying with Joe Sanders of Tamani Africa who had helped run and built the standalone VCT in Kendu Bay. Joe was quite the character having been jack-of-all-trades of sort over the course of his life. He had done such things as: spending nine years as in navy special forces in the Vietnam era, made about $8,000 a week as a pool hustler for a year in the 1970’s before finding God as an 7th day Adventist, run a carnival, been a bodyguard, transferred hundreds of millions of dollars for the federal reserve and a myriad of other things. While in Kendu Bay we stayed with Joe and a family that he helped build a house for and worked with. They were an extremely kind and hospitable family with the husband, William, doing everything he could to help us and feel at home. The area there was extremely beautiful with foliated rolling hills and spattered stone outcroppings bordering vast Lake Victoria, reminding me of a more humid San Diego. Liverpool has offered to help us recruit an additional counselor and gave us perspective on how they operate their mobile clinic activities. Currently we’re getting the approval process rolling with meeting the district health official later this week and setting up appointments for facility inspections.Thanks for all the birthday wishes last week. I’m sorry I hadn’t posted an update until this point, hopefully I’ll have access to the internet more than once a week in the future. If anyone wants to or needs to give us a call we can be contacted via Krishna’s phone at: 254-738804388. I would highly recommend getting a phone card or using Skype or some other method of cutting the cost though.I just got back from a Kenyan Presidential Rally in Bungoma. It's an election year here so the president had a rally. Needless to say it was interesting, especially since we got to sit up front next to the stage in the front row where all the Kenyan officials and other bigwigs sat. More soon hopefully.Thanks,Josh

First Day in Kenya

I made it safely into Nairobi last night after far too many hours in travel. Krishna and I had a quick pick up at the airport which took us to the bus station only to find out the bus to Bungoma had already been fully booked for today so we shall be departing Nairobi on Saturday morning instead. We spent the night at the Upper Hill Campsite in Nairobi right next to the Indonesian Embassy and around the corner from the British Council. At the hostel last night we met another volunteer from ICODEI that left today for Bungoma and we are to talk about the program for a short while with her. Today we've lucky enough to tag along with a young Australian woman that had been volunteering for the last four months and is waiting for a flight out on Sunday. I can't really say much about Kenya yet as I haven't seen much yet. Nairobi is an interesting city as it seems there is no zoning laws with sky scraper scattered about in no particular order next to houses and empty losts alike. Gonna take me a while to get used to be people driving on the left side of the road. Hopefully I'll be able to post many more in depth ones as I see more of the country.Josh